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Senior Medical Claims Project Coordinator
2 months ago
Company Overview:
Privia HealthTM is a forward-thinking, national physician enablement organization that partners with medical groups, health plans, and healthcare systems to enhance physician practices, elevate patient experiences, and incentivize physicians for delivering high-value care in both in-person and virtual environments. The Privia Platform is spearheaded by top-tier industry professionals and outstanding physician leadership, featuring scalable operations and comprehensive, cloud-based technology designed to minimize unnecessary healthcare expenditures, achieve superior outcomes, and enhance the health of patients alongside the well-being of providers.
This role operates in a hybrid full-time capacity, requiring in-office attendance on designated days, while allowing for remote work on others, subject to change for internal engagements.
Reporting to the Manager of Revenue Cycle Management, the Senior Medical Claims Project Coordinator is tasked with consolidating responsibilities among the AVP of RCM, the Manager of Revenue Optimization, and the Manager of Revenue Cycle Management. This role involves conducting research for intricate Revenue Cycle initiatives and engaging in specialized projects as assigned by the leadership team.
Key Responsibilities:- Analyze and interpret RCM reports, identifying denial sources and revenue cycle patterns.
- Collaborate closely with the Revenue Optimization team to ensure reimbursement aligns with payer contract stipulations, performing denial analysis using the Trizetto platform.
- Drive the achievement of departmental daily and monthly Key Performance Indicators (KPIs) through a team-oriented approach.
- Audit all RCM Management Reports for accuracy and identify opportunities for enhancement.
- Effectively communicate and escalate RCM issues and concerns as necessary.
- Perform additional duties as assigned.
- Education: High School diploma required.
- Experience: Minimum of 5 years in medical claims within a physician billing environment.
- Comprehensive understanding of revenue cycle performance drivers and the ability to investigate and resolve complex claims.
- Familiarity with Explanation of Benefit (EOB) statements.
- Proficient in Microsoft Excel; experience with Google Suite preferred.
- Experience with athena EMR is advantageous.
- Comfortable presenting in front of groups.
- Exceptional written and verbal communication skills.
- Self-motivated with strong time management abilities and the capacity to manage multiple projects simultaneously.
- Ability to work independently and multitask in a dynamic environment.
- Strong problem-solving skills with a solution-oriented mindset.
- Excellent research capabilities.
- Adherence to HIPAA regulations is mandatory.
- Must have access to a private, quiet workspace with high-speed internet for remote work.
Compensation:
The salary range for this position is between $50,000 and $60,000, with eligibility for an annual bonus targeted at 15% based on performance metrics. The final base pay will be determined by relevant factors such as experience, education, and geographic location.
All information will be maintained confidentially in accordance with EEO guidelines.
Technical Requirements:
For remote workers, a minimum internet speed of 5 MBPS for download and 3 MBPS for upload is required prior to employment commencement. Regular remote workers may be eligible for expense reimbursement to offset internet costs.
Privia Health is dedicated to fostering a work environment that encourages individuals to bring their authentic selves to work. We believe that our organization is stronger when our workforce reflects the diverse communities we serve. We are committed to providing equal opportunities regardless of age, color, national origin, physical or mental disability, race, religion, gender, sexual orientation, gender identity or expression, marital status, veteran status, or any other characteristic protected by law.
