Medical Claims Billing Specialist
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Job Location:
Houston, MS - USA
Monthly Salary:
Not Disclosed
Posted on:
2 hours ago
Vacancies:
1 Vacancy
Job Summary
*This position is a hybrid full-time role that requires in office on Tuesdays and Thursdays at 1200 Binz St Suite 1490 Houston TX 77004. Mon Wed and Fri are typically work from home but subject to change for internal meetings trainings and conferences.*
Under the direction of the Sr. Manager of Revenue Cycle Management the Medical Claims Billing Specialist - Case Management (AR Manager) is responsible for complete accurate and timely processing of all designated claims reviewing and responding to daily correspondence from physician practices in a timely manner answering incoming SalesForce cases and providing information as requested or properly authorized. The Medical Claims Specialist will take steps necessary to resolve all claim issues or questions that escalate to the RCM team.
Primary Job Duties:
Denial management - investigating denial sources resolving and appealing denials which may include contacting payer representatives
Makes independent decisions regarding claim adjustments resubmission appeals and other claim resolution techniques
Collaborate with internal teams (Performance Operations Sales) as well as care center staff when appropriate
Works closely with our Revenue Optimization team to support efforts to ensure reimbursement is in line with payer contract agreements.
Work directly with practice consultants or physicians to ensure optimal revenue cycle functionality
Drive toward achievement of departments daily and monthly Key Performance Indicators (KPIs) requiring a team focused approach to attainment of these goals
Other duties as assigned
Qualifications :
- Education: High School diploma
Experience: 3 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.
- Advanced Microsoft Excel skills (ex: pivot tables VLOOKUP sort/filtering formulas) preferred
Must understand Explanation of Benefit (EOB) statements
Google Suite experience preferred
Athena EMR experience preferred
Must provide accessibility to private quiet work space with high-speed internet to effectively work remotely for days not in the office
Comfortable speaking in front of groups
Excellent written and verbal communication
Willingness to train and mentor other team members
Self-starter with great time management skills
Ability to work independently and multi-task in a fast paced environment
Problem solver with good analytical skills and solution-oriented approach
Independent decision maker with strong research skills
Must comply with HIPAA rules and regulations
The hourly range for this role is $24/hr - 26.45/ hr 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 10% based on performance in the role. 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 :
No
Employment Type :
Full-time
Key Skills
- Medical Collection
- Accounts Receivable
- Athenahealth
- ICD-10
- Medical Coding
- 10 Key Calculator
- Detailing
- ICD-9
- Medical Billing
- Microsoft Excel
- CPT Coding
- Medicare
About Company
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
