Insurance Credit Resolution Specialist

Privia Health

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profile Job Location:

Any - USA

profile Monthly Salary: Not Disclosed
Posted on: 30+ days ago
Vacancies: 1 Vacancy

Job Summary

Under the direction of the Sr. Manager Revenue Cycle Management the Insurance Credit Resolution Specialist is responsible for complete accurate and timely processing of all assigned insurance related credits. Processing of these credits includes reviewing and responding to daily correspondence from physician practices in a timely manner answering incoming inquiries preparing insurance refund checks for mailing and processing returned checks.  

  • Implement payer specific workflows for void requests take back requests and insurance refund initiations
  • Research and resolve overpaid and denied claims in athenaNet
  • Use Salesforce to manage worklists and requests/inquiries from Care Centers
  • Successfully process 35 insurance refunds daily

    In office specific duties:
  • Utilize athenaNet software to identify and print appropriate insurance refund letters
  • Enter insurance refund check #s into athenaNet for tracking 
  • In the absence of a payer refund letter use letter template to make custom refund letters 
  • Prepare checks to be mailed including matching checks with refund letter folding inserting addressing and sealing envelopes 
  • Sorting checks by payer
  • Retrieve and process returned checks accordingly 
  • Other duties as needed

Qualifications :

  • Education: High School Graduate Medical Office training certificate or relevant experience
  • 3 years experience in physician revenue cycle / claims management
  • Background with posting charges claim follow up collections and payment posting
  • Must have experience working with athenahealths suite of tools
  • Must comply with HIPAA rules and regulations

The hourly range for this role is $25.00-$26.45 in base pay and exclusive of any bonuses 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 10%. The base pay offered will be determined based on relevant factors such as experience education and geographic location.


Additional Information :

All 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. We understand that healthcare is local and we are better 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

Under the direction of the Sr. Manager Revenue Cycle Management the Insurance Credit Resolution Specialist is responsible for complete accurate and timely processing of all assigned insurance related credits. Processing of these credits includes reviewing and responding to daily correspondence from ...
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Key Skills

  • Sales Experience
  • Time Management
  • Marketing
  • Customer Service
  • Communication skills
  • Retail Sales
  • Business Management
  • Outside Sales
  • Telemarketing
  • Insurance Sales
  • Medicare
  • Phone Etiquette

About Company

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Privia Health™ is a national physician platform transforming the healthcare delivery experience. We provide tailored solutions for physicians and providers, creating value and securing their future. Through high-performance physician groups, accountable care organizations, and popul ... View more

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