Claims Billing Specialist – Athena EMR

🔥 7 minutes ago

🇺🇸 United States – Remote

💵 $24 - $26 / hour

⏰ Full Time

🟡 Mid-level

🟠 Senior

📊 Billing Specialist

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This company has sponsored H1B visas in the past.

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Privia Health

WebsiteLinkedInAll Job Openings

501 - 1000 employees

🏥 Healthcare

💳 Fintech

💰 $450M Post-IPO Equity on 2021-04

Healthcare • Fintech

Privia Health is a national physician platform transforming the healthcare delivery experience. They provide tailored solutions for physicians and providers, creating value and securing their future. Through high-performance physician groups, accountable care organizations, and population health management programs, Privia collaborates with health plans, health systems, and employers to better align reimbursements to quality and outcomes.

📋 Description

• Ensure accurate and timely processing of all assigned claims • Address daily correspondence from physician practices • Review and appeal insurance claim denials • Follow up on aged claims • Resolve claim issues and questions escalated to the Revenue Cycle Management team, including Salesforce case management • Manage accounts receivable, analyze aged AR, identify root-cause issues, and suggest billing rules/edits • Investigate denial sources and resolve or appeal denials, including contacting payer representatives by phone • Make decisions regarding claim adjustments, resubmissions, appeals, and other claim-resolution techniques • Collaborate with Performance, Operations, Sales, and care center staff • Support large care center go-lives, which may include overnight travel • Work with the Revenue Optimization team to align reimbursement with payer contract agreements • Perform denial analysis using the Trizetto platform • Work with practice consultants or physicians to ensure optimal revenue cycle functionality • Drive achievement of daily and monthly department KPIs • Perform other duties as assigned

🎯 Requirements

• High School Graduate • 3+ years experience in a medical billing office or equivalent claims experience • Must understand the drivers of revenue cycle optimal performance and be able to investigate and resolve complex claims • Advanced Microsoft Excel/Google Sheets skills preferred, including pivot tables, VLOOKUP, sorting/filtering, and formulas • Experience with athenaHealth and/or athenaOne highly preferred • Experience working with New Jersey payers and providers preferred • Must comply with HIPAA rules and regulations • Independent decision maker with strong research skills • Minimum 5 MBPS download speed and 3 MBPS upload speed for remote work • Must obtain the required internet speed before employment begins

🏖️ Benefits

• Annual bonus targeted at 10% based on performance in the role • Medical insurance • Dental insurance • Vision insurance • Life insurance • Pet insurance • 401K • Paid time off • Wellness programs • Expense reimbursement for employees who regularly work from home offices • Remote work arrangement • Overnight travel support for large care center go-lives, when applicable

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