AR Manager

About the role

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.

Responsibilities

• Process all designated claims completely, accurately, and timely.
• Review and respond to daily correspondence from physician practices in a timely manner.
• Answer incoming SalesForce cases and provide information as requested or properly authorized.
• Take steps necessary to resolve all claim issues or questions that escalate to the RCM team.
• Resolve SalesForce cases and manage issues and the team resolving the cases.
• Oversee functions within Accounts Receivable in accordance with compliant best practices, such as Claims Worklists, Zero Pay, Unapplied, and Denials, ensuring review, reconciliation, and timely resolution.
• Serve as a subject matter expert and point of escalation on an internal sub‑team.
• Manage accounts receivable including analysis of aged AR, identify root‑cause issues, and write rules to prevent errors.
• Handle denial management: investigate denial sources, resolve and appeal denials, which may include contacting payer representatives.
• Make independent decisions regarding claim adjustments, resubmission, appeals, and other claim resolution techniques.
• Serve as an escalation point and escalate issues to the appropriate party.
• Suggest and lead policy updates as needed.
• Work directly with practice consultants and/or physicians via Salesforce to ensure optimal revenue cycle functionality.
• Drive achievement of department’s daily and monthly KPIs through a team‑focused approach.
• Perform other duties as assigned.

Qualifications

• High School Graduate.
• 5+ years experience in a physician medical billing office or equivalent claims experience.
• Understand the drivers of revenue cycle optimal performance and ability to investigate and resolve complex claims.
• Microsoft Excel skills (pivot tables, VLOOKUP, sort/filtering, formulas) preferred.
• Experience working with athenaOne preferred.
• Experience using Salesforce for case management preferred.
• Must provide accessibility to a private, quiet work space with high‑speed internet to work remotely (if a remote worker).
• Experience with VA payers & providers preferred.
• Must comply with HIPAA rules and regulations.
• Excellent written and verbal communication.

Skills

• Microsoft Excel (pivot tables, VLOOKUP, sort/filtering, formulas).
• Salesforce case