Medical Claims Biller

5 days ago


Houston, Texas, United States Privia Health Full time

Overview

Privia Health is a technology-driven company that collaborates with medical groups, health plans, and health systems to optimize physician practices and improve patient experiences. As an Ancillary AR Manager (medical claims biller), you will play a crucial role in ensuring the accurate and timely processing of all claims for our Lab Ancillary.

Salary and Benefits

The salary range for this role is $55,000 to $60,000 in base pay, with an annual bonus targeted at 10% based on performance in the role.

Job Description

We seek a highly organized individual with years of experience in laboratory medicine to manage the accounts receivable (AR) process, including analysis of aged AR, identifying root cause issues, and suggesting billing rules/edits when appropriate. This role also involves maintaining current knowledge of payer regulations, analyzing billing metrics to report on performance impacts, and driving toward achievement of department's daily and monthly Key Performance Indicators (KPIs).

Key Responsibilities:

  • Manage the accounts receivable (AR) process, including analysis of aged AR, identifying root cause issues, and suggesting billing rules/edits when appropriate
  • Maintain current knowledge of payer regulations, including ICD-10 and CPT codes
  • Analyze billing metrics to report on performance impacts and identify opportunities for improvement
  • Drive toward achievement of department's daily and monthly KPIs
  • Investigate denial sources, resolve and appeal denials which may include contacting payer representatives

Requirements and Qualifications

  • High School Graduate
  • Experience in laboratory billing, billing software, EDI enrollment, and payer portals required
  • 5+ 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 preferred

What We Offer

At Privia Health, we are committed to creating and fostering a work environment that allows and encourages you to bring your whole self to work. We strive to be an inclusive organization where everyone feels welcome and valued. 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.



  • Houston, Texas, United States ABETTERHOMECARE Full time

    Job DescriptionOverview:ABETTERHOMECARE seeks a highly skilled and detail-oriented Medical Claims Specialist to join our team. The ideal candidate will have a strong background in medical billing and a passion for delivering exceptional patient care.Duties and Responsibilities:Process patient fees and charges efficiently and accurately.Collect payments from...


  • Houston, Texas, United States St. Josephs Medical Center Full time

    Company Overview:St. Joseph Medical Center is a world-class healthcare provider, dedicated to delivering exceptional care to the community of Houston for over 137 years.We pride ourselves on our tradition of compassion and innovation, ensuring that every patient receives personalized attention and top-notch treatment.About the Role:This exciting opportunity...


  • Houston, Texas, United States Medical AR Management Services, LLC Full time

    Job SummaryWe are seeking an experienced AR Collections Specialist to join our team at Medical AR Management Services, LLC.About the RoleThis is a challenging and rewarding position that requires strong analytical skills, attention to detail, and excellent communication abilities. The successful candidate will be responsible for managing accounts receivable,...


  • Houston, Texas, United States Dane Street Full time

    Join Dane Street as a highly skilled OB/GYN Physician to review medical claims and provide expert interpretations. This role offers the flexibility to customize your schedule and caseload within the week, ensuring a great work-life balance.We are seeking an experienced physician with an active Texas License to work as an independent contractor on a per-case...


  • Houston, Texas, United States MET Healthcare Solutions Full time

    About the RoleWe are seeking a highly skilled Claims Eligibility Specialist I to join our team at MET Healthcare Solutions in Houston, Texas. This is a full-time position requiring your presence in our corporate office 2-3 times per week.Estimated Salary: $62,000 - $72,000 per year, based on experience and qualifications.The ideal candidate will have...


  • Houston, Texas, United States Gallagher Bassett Full time

    Job SummaryPursue a challenging role as a Senior Claims Specialist with Gallagher Bassett, where you will investigate, evaluate, and resolve complex Architect & Engineer Professional Liability claims. This position requires a strong background in claims handling, analytical skills, and the ability to work independently.About the RolePassword negotiation and...


  • Houston, Texas, United States Medical AR Management Services, LLC Full time

    Company OverviewMedical AR Management Services, LLC is a dynamic organization dedicated to delivering exceptional medical accounts receivable management solutions.Job SummaryWe are seeking an experienced Error Processing Specialist to join our team. The successful candidate will be responsible for resolving front-end and back-end errors related to claims...


  • Houston, Texas, United States MET Healthcare Solutions Full time

    Job OverviewMET Healthcare Solutions, a leading healthcare management group, is seeking an experienced Medical Claims Eligibility Specialist II to join their team. This hybrid position combines in-office training with remote work opportunities.The ideal candidate will have a strong background in healthcare claims analysis and possess excellent analytical,...


  • Houston, Texas, United States Law Firm Full time

    Job OverviewThe Law Firm is seeking an experienced Claims Manager to handle personal injury cases from intake to resolution. The ideal candidate will have a strong background in general claims management, with expertise in car wrecks and 18 wheeler wrecks.About the RoleThis role requires extensive experience in case screening, client follow up, supervision...

  • Claim Specialist

    4 weeks ago


    Houston, Texas, United States 020 Travelers Indemnity Co Full time

    Job SummaryAt 020 Travelers Indemnity Co, we are seeking an experienced Claim Specialist to join our team. The successful candidate will be responsible for investigating, evaluating, reserving, negotiating, and resolving assigned Specialty Liability related Bodily Injury and Property Damage claims.Key ResponsibilitiesTimely coverage analysis and...


  • Houston, Texas, United States Westside KIA Full time

    Westside KIA Automotive Dealership is a family-owned business in Katy, TX, offering a rewarding career opportunity for an experienced Warranty Administrator. We are seeking a skilled professional to process automotive warranty repair claims according to dealership and manufacturer policies.Job Summary:The successful candidate will prepare, submit, and track...


  • Houston, Texas, United States Premier Medical Resources Full time

    Medical Billing Specialist Role at Premier Medical ResourcesPremier Medical Resources is a healthcare management company headquartered in Northwest Houston, Texas.Our goal is to leverage and combine the expertise and skillset of our employees to drive quality in all we do. We strive to create career pathways for our employees just starting their professional...


  • Houston, Texas, United States Schouest, Bamdas, Soshea, BenMaier and Eastham, PLLC Full time

    Job OverviewSchouest, Bamdas, Soshea, BenMaier & Eastham PLLC is a prominent defense law firm with offices in key locations across the United States.We are seeking a skilled Defense Attorney to join our team and assist with Defense Base Act claims.About the RoleThis exciting opportunity allows you to work with our experienced attorneys on a variety of cases,...


  • Houston, Texas, United States TEKsystems Full time

    About the Role:As a Pharmaceutical Claims Consultant at TEKsystems, you will play a crucial role in supporting patients with limited financial resources. Your expertise will be instrumental in navigating complex insurance programs, ensuring timely and accurate reimbursement for specialty medications. This is an exciting opportunity to make a meaningful...


  • Houston, Texas, United States The Law Offices of Kanner & Pintaluga P A Full time

    About the RoleWe are seeking a highly skilled and compassionate Pre-Litigation Attorney to join our team at The Law Offices of Kanner & Pintaluga P A in Houston, TX.Job SummaryThis role involves meeting with clients to discuss their cases, providing them with updates, and communicating with insurance companies regarding claim status, demands, and offers.Key...


  • Houston, Texas, United States Highspeed Staffing Inc Full time

    About the role: Personal Injury Case ManagerThe Personal Injury Case Manager is a critical support professional who will act as the main liaison for our clients. As the primary point of contact, you will be responsible for managing case files, coordinating with insurance companies, and providing exceptional customer service to our clients.This is a full-time...


  • Houston, Texas, United States Pride Health Full time

    Job Summary:">">We are seeking a detail-oriented Medical Coder to join our team, who has expertise in medical coding, claims analysis, and reimbursement policies.">About the Role:">The successful candidate will analyze large claims data sets, review provider billing patterns, ensure compliance with coding regulations, and support the development and...


  • Houston, Texas, United States JL4 Staffing Full time

    Job SummaryWe are seeking a skilled Medical Collector Senior Specialist to join our team at JL4 Staffing. As a key member of our collection unit, you will be responsible for providing medical collection services and resolving accounts in accordance with client and state guidelines.Key Responsibilities:Provide effective collection services, ensuring the...


  • Houston, Texas, United States Aveanna Healthcare Full time

    OverviewAveanna Healthcare is a leading provider of home healthcare services. Our mission is to deliver exceptional patient care and support our staff in achieving their career goals.Salary$90,000 - $120,000 per annum, depending on experience and qualifications.Job DescriptionWe are seeking a highly skilled Medical Operations Director to lead our Therapy...


  • Houston, Texas, United States The College of Health Care Professions Full time

    Job Title: Medical Billing and Coding SpecialistWe are seeking a skilled Medical Billing and Coding Specialist to join our team at The College of Health Care Professions. As an adjunct instructor, you will play a crucial role in shaping the next generation of medical billing and coding professionals.About the Job:This part-time position involves delivering...