Unpostables Medical Claims Biller

  • Full-time
  • Department: Revenue Cycle

Company Description

Privia Health™ is a technology-driven, national physician enablement company that collaborates with medical groups, health plans, and health systems to optimize physician practices, improve patient experiences, and reward doctors for delivering high-value care in both in-person and virtual settings. The Privia Platform is led by top industry talent and exceptional physician leadership, and consists of scalable operations and end-to-end, cloud-based technology that reduces unnecessary healthcare costs, achieves better outcomes, and improves the health of patients and the well-being of providers.

Job Description

Under the direction of the Manager, Unpostables of Revenue Cycle Management, the Accounts
Receivable (AR) Manager - Unpostables is responsible for overseeing the unpostables process within
the RCM National Team. They identify, research and resolve unapplied cash, unidentified payments, and
other discrepancies in patient accounts. The AR Manager - Unpostables ensures timely resolution of
unpostable records, maintaining accurate records, and collaborating with other departments to improve
processes and minimize unpostable occurrences. This role will also be responsible for taking the steps
necessary to resolve all issues or questions that escalate to the unpostables team to include SalesForce
case management.

Primary Job Duties:

  • Unpostables management that includes researching and resolving records that have not been
    matched to athenaOne related charges (including insurance payments, capitation payments,
    patient payments, remittance items and voided charges)
    • Reconciliation of re-adjudicated claims/payer takebacks
    • Make independent decisions regarding claim adjustments, resubmission, appeals, and other claim resolution techniques as needed
    • Maintain payer web portal access for all payers and interfaces with athenaOne
    • Responsible for training internal teams (Operations, Sales) as well as care center staff when
    appropriate.
    • Work directly with practice consultants or physicians to ensure optimal revenue cycle functionality
    • Drive toward achievement of department’s daily and monthly Key Performance Indicators (KPIs)
    • Other duties as assigned

Qualifications

  • • 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 skills (ex: pivot tables, VLOOKUP, sort/filtering, formulas)
    • Experience with athenaHeath and/or athenaOne preferred
    • Must comply with HIPAA rules and regulations

The hourly range for this role is $24/hr to $26.45/hr in hourly 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 10%. 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 https://www.speedtest.net/. 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. We understand that healthcare is local and we are better 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.  

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