Manager, Revenue Cycle (Athena/Washington)

Under the Direction of the Sr Director Revenue Cycle Management the Manager Revenue Cycle Management is responsible for overseeing the claims and collections process within the organizations revenue cycle. This role involves managing a team to ensure timely and accurate claims submissions follow-up and resolution of outstanding accounts receivable. The Manager is responsible for ensuring that the Accounts Receivables are worked in accordance with best practices and that all Manager Holds Zero Pay Unapplied Unpostables and other Aged Accounts Receivable are reviewed reconciled and resolved in a timely and compliant manner. The Manager is response for monitoring the teams performance and will take steps necessary to resolve claim issues or questions that escalate to the RCM team. The ideal candidate will have strong leadership skills extensive experience in claims management and the ability to work collaboratively with internal departments and external stakeholders such as insurance companies.

Primary Job Duties:

Oversee the entire claims submission and follow-up process ensuring claims are submitted accurately and on time; specifically focused on Manager Holds with oversight of HOLDs Zero Pay Unapplied and Unpostables
Lead and manage a team of AR specialists providing guidance training and support
Monitor outstanding accounts receivable focusing on resolving aging claims and minimizing write-offs
Ensure that denied claims are appealed in a timely manner and in accordance with payer guidelines
Monitor and ensure all SalesForce cases are responded to and managed in a timely manner
Conduct regular performance reviews and offer continuous coaching to improve team efficiency and productivity
Identify opportunities for process improvements in the claims and AR workflows implementing best practices to streamline operations
Generate and analyze AR reports providing insights into key metrics such as aging reports denial trends and collection rates
Utilize data to identify patterns in claim denials or delays and develop actionable solutions to address them
Liaise with insurance companies patients and internal departments (operations national RCM teams finance) to resolve claim issues and disputes
Serve as the point of escalation for complex or high-value claims working to resolve issues in a timely manner
Other duties as assigned

Qualifications :

• High School Graduate Medical Office training certificate or relevant experience
• AthenaOne EMR experience required 
• RHC experience preferred
• WA regional experience required 
• 4 experience in 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.
• Experience reporting and tracking accounts receivable
• Experience working with Trizetto and SalesForce preferred
• Advanced Microsoft Excel skills (ex: pivot tables VLOOKUP sort/filtering formulas) preferred
• Medical coding / billing experience preferred
• Must comply with HIPAA rules and regulations

The salary range for this role is $70000 to $75000 in base pay and exclusive of any bonus 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 15% based on the performance for the role and resricted stock units. The base pay offered will be determined based on relevant factors such as experience education and geographic location. 

Additional Information :

All of 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 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. Privia is a better company 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.  

Remote Work :

Yes

Employment Type :

Full-time