Privia Health™ 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. The Privia Platform is led by top industry talent and exceptional physician leadership, and consists of scalable operations and end-to-end, cloud-based technology that reduces unnecessary healthcare costs, achieves better outcomes, and improves the health of patients and the well-being of providers
This role requires hybrid work in our Arlington, VA office
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.
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.
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 https://www.speedtest.net/. 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.
Manage end-to-end ASC billing, from surgical claim preparation and submission to payer follow-ups, denial resolution, appeals, and accounts receivable, while supporting accurate documentation and patient communication.
Manage patient balances and billing inquiries within a centralized revenue cycle, reconciling accounts, addressing invalid balances, applying financial assistance, processing refunds, and maintaining accurate patient records.
Manage the medical billing lifecycle from claim submission through payment posting and follow-up, resolving denials, applying payer requirements, and supporting providers and patients with billing questions.
Manage medical billing and revenue-cycle tasks, including charge entry, claim submission, payment posting, denial follow-up, and patient account support using NextGen Billing.
Analyze hospital claims to identify reimbursement underpayments, investigate billing and payer-policy discrepancies, resolve issues with insurers, and document findings that improve payment accuracy and revenue integrity.
