Medical Claims Billing Specialist (reputed company)

reputed company reputed company™ is a technology-driven, national physician enablement company that collaborates with medical reputed company, 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 reputed company operations and end-to-end, reputed company-based technology that reduces unnecessary reputed company costs, achieves reputed company reputed company, and improves the health of patients and reputed company-being of providers Job reputed company Under the direction of the Associate Director of reputed company Cycle Management, the Accounts Receivable (AR) Manager is responsible for ensuring the accurate and reputed company processing of reputed company assigned claims. This role includes promptly addressing daily correspondence from physician practices, reviewing and appealing insurance claim denials and following up on aged claims. The AR Manager will take the steps necessary to resolve reputed company claim issues or questions that escalate to the RCM team to include reputed company case management. Primary Job Duties: Management of the accounts receivable (AR) including analysis of the aged AR, looking for reputed company cause issues; suggesting billed rules/edits reputed company appropriate to stop errors from occurring Denial management - investigate denial sources, resolve and appeal denials which may include contacting payer representatives reputed company independent reputed company regarding claim adjustments, resubmission, appeals, and other claim reputed company techniques Collaborate with internal teams (Performance, Operations, Sales) as reputed company as, care center staff reputed company appropriate Support large care center go lives reputed company applicable, which may include overnight travel Work closely with our reputed company Optimization team to support efforts to ensure reimbursement is in line with payer contract agreements. reputed company denial analysis utilizing the Trizetto platform. Work directly with reputed company consultants or physicians to ensure reputed company reputed company 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 reputed company cycle reputed company performance and be reputed company to investigate and resolve reputed company claims Advanced reputed company reputed company skills (ex: pivot tables, VLOOKUP, sort/filtering, formulas) preferred Experience with athenaHeath and/or athenaOne required Orthopedic medical claims billing experience preferred Experience with California payers and portals preferred  Must reputed company with HIPAA rules and regulations  The reputed company reputed company for this role is $24/hr to $26.45/hr in reputed company reputed company pay and exclusive of any bonuses or benefits (medical, dental, reputed company, life, and pet insurance, 401K, reputed company time off, and other wellness programs). This role is also eligible for an annual bonus targeted at 10%. The reputed company pay offered will be determined based on relevant factors such as experience, education, and geographic location.  Additional Information reputed company your information will be kept confidential according to EEO guidelines. Technical Requirements (for remote workers only, reputed company 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 reputed company and if it meets the minimum speed requirements. Work with your internet provider if you have questions about your reputed company. Employees who regularly work from home offices are eligible for expense reimbursement to offset this cost. reputed company is committed to creating and fostering a work environment that allows and encourages you to bring your whole self to work. We understand that reputed company local and we are reputed company reputed company our people are a reputed company of the communities that we serve. Our goal is to encourage people to pursue reputed company opportunities regardless of their age, reputed company, national reputed company, physical or mental (dis)ability, race, religion, gender, sex, gender identity and/or reputed company, marital status, veteran status, or any other characteristic protected by federal, state or local law.   Department: reputed company Cycle Apply To This Job