Biller Claims Specialist
Biller Claims Specialist
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Not Disclosed
Salary Not Disclosed
1 Vacancy
Job Description
Under the supervision of the CODER/BILLER Program Manager the Biller AR Manager is responsible for complete accurate and timely processing of all designated claims reviewing and responding to daily correspondence from physician practices answering incoming telephone calls and providing information as requested or properly authorized. This person will assist in Coder/Biller golive training as well as communicate closely with providers and practice staff. The ideal candidate possesses strong follow up skills attention to detail and takes pride in successfully resolving issues. This position works collaboratively with the staff in our physician practices as well as team members at Privia.
Primary Job Duties:
HOLD and Denial Management:
Investigate denial sources; resolve and appeal HOLDs / Denials which may include contacting payer representatives.
Independently decide how to adjust claims including resubmission appeals and other claim resolution techniques.
Assist in performing CODER/BILLER trainings in collaboration with market RCM teams.
Research and answer BILLER claim HOLD questions; deliver instructions to the providers and practice staff.
Manage Salesforce cases
Route claims to the appropriate owner
Manage all Biller cases
Manage all Coder cases
Serves as the primary escalation point by working with the vendor to resolve coding issues and relaying resolutions to the care center
Monitor and respond to emails timely
Follow guidelines and legal requirements to ensure compliance with federal and state regulatory bodies.
Collaborate with Success Management on Checkin meetings for overall program success and client satisfaction
Provide HOLDs breakdown and aging report
Identify trends and solicit feedback from the Care Center to improve program success
Review current HOLDs in the practice worklist and set expectations
Provide additional training sessions with the Care Center as requested
Cleanup projects for escalated care centers
Qualifications :
High School diploma Medical Office training certificate or relevant experience preferred
Claim and denials management experience required
3 years of experience in medical billing office preferred
Must understand the drivers of revenue cycle optimal performance and be able to investigate and resolve complex claims
Strong preference for experience working with athenaHealths suite of tools
Must provide accessibility to private quiet work space with highspeed internet to effectively work remotely
Must comply with HIPAA rules and regulations
Ability to work effectively with physicians Nonphysician practitioners (NPP) practice staff health plan/other external parties and Privia multidisciplinary team
The salary range for this role is $115000.00$125000.00 in base pay and exclusive of any bonuses or benefits (medical dental vision life and pet insurance 401K paid time off and other wellness programs). This role is also eligible for an annual bonus targeted at 15% based on the performance for the role and resricted stock units. The base pay offered will be determined based on relevant factors such as experience education and geographic location.
Additional Information :
All your information will be kept confidential according to EEO guidelines.
Technical Requirements (for remote workers only not applicable for onsite/in office work):
In order to successfully work remotely supporting our patients and providers we require a minimum of 5 MBPS for Download Speed and 3 MBPS for the Upload Speed. This should be acquired prior to the start of your employment. The best measure of your internet speed is to use online speed tests like This gives you an update as to how fast data transfer is with your internet connection and if it meets the minimum speed requirements. Work with your internet provider if you have questions about your connection. Employees who regularly work from home offices are eligible for expense reimbursement to offset this cost.
Privia Health is committed to creating and fostering a work environment that allows and encourages you to bring your whole self to work. Privia is a better company when our people are a reflection of the communities that we serve. Our goal is to encourage people to pursue all opportunities regardless of their age color national origin physical or mental (dis)ability race religion gender sex gender identity and/or expression marital status veteran status or any other characteristic protected by federal state or local law.
Remote Work :
Yes
Employment Type :
Fulltime
Employment Type
Remote
Company Industry
Key Skills
- EMR Systems
- Medical Collection
- Athenahealth
- eClinicalWorks
- ICD-10
- Medical Coding
- Medical office experience
- ICD-9
- Medical Billing
- Medical Terminology
- CPT Coding
- Medicare
