Revenue Cycle Project Specialist

3 days ago


Houston, Texas, United States Privia Health LLC Full time
Job Description

**About Privia Health LLC**

Privia Health LLC 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.

**Job Summary**

We are seeking a highly skilled Revenue Cycle Project Specialist to join our team. The successful candidate will be responsible for the consolidation of tasks between the AVP of RCM, the Manager of Revenue Optimization, and the Manager of Revenue Cycle Management. This position will be responsible for research for complex Revenue Cycle projects and working on specialized projects given by the leadership team.

Key Responsibilities

  • Runs, reviews, and analyzes RCM reports and communicates denial sources and revenue cycle trends.
  • Works closely with the Revenue Optimization team to support efforts to ensure reimbursement is in line with payer contract agreements. Performs Denial analysis utilizing the Trizetto platform.
  • Drives toward achievement of department's daily and monthly Key Performance Indicators (KPIs), requiring a team-focused approach to attainment of these goals.
  • Responsible for auditing all RCM Management Reports to ensure accuracy and to identify areas of opportunity for improvement.
  • Ability to effectively communicate and escalate RCM issues and areas of concern.
  • Other duties as assigned.

Requirements

  • Education: High School diploma
  • Experience: 5+ years medical claims experience in a physician medical billing office
  • Must understand the drivers of revenue cycle optimal performance and be able to investigate and resolve complex claims.
  • Must understand Explanation of Benefit (EOB) statements.
  • Advanced Microsoft Excel skills.
  • Google Suite experience preferred.
  • Preference for experience working with athena EMR.
  • Comfortable speaking in front of groups.
  • Excellent written and verbal communication skills.
  • Self-starter with great time management skills and ability to work on multiple projects at one time.
  • Ability to work independently and multi-task in a fast-paced environment.
  • Problem solver with good analytical skills and solution-oriented approach.
  • Strong research skills.
  • Must comply with HIPAA rules and regulations.
  • Must provide accessibility to private, quiet work space with high-speed internet to effectively work remotely for days not in the office.

Compensation

The salary range for this role is $50,000 to $60,000 in base pay. This role is also eligible for an annual bonus targeted at 15% based on performance in the role. The base pay offered will be determined based on relevant factors such as experience, education, and geographic location.



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