AR Representative (New Jersey, Neurology)

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.

About the role

Under the direction of the Associate Director of Revenue Cycle Management, the Accounts Receivable (AR) Manager ensures the accurate and timely processing of all assigned claims. This role includes promptly addressing daily correspondence from physician practices, reviewing and appealing insurance claim denials, and following up on aged claims. The AR Manager resolves escalated claim issues or questions using Salesforce case management.

Responsibilities

• Manage accounts receivable (AR), including analysis of aged AR to identify root cause issues and suggest billed rules/edits to prevent errors
• Handle denial management: investigate denial sources, resolve and appeal denials, including contacting payer representatives
• Make independent decisions regarding claim adjustments, resubmission, appeals, and other claim resolution techniques
• Collaborate with internal teams (Performance, Operations, Sales) and care center staff
• Support large care center go-lives as applicable
• Work closely with the Revenue Optimization team to ensure reimbursement aligns with payer contract agreements
• Perform denial analysis using the Trizetto platform
• Work directly with practice consultants or physicians to ensure optimal revenue cycle functionality
• Drive toward achievement of the department’s daily and monthly Key Performance Indicators (KPIs)
• Perform other duties as assigned

Requirements

• High School Graduate
• 3+ years of experience in a medical billing office or equivalent claims experience
• Understanding of revenue cycle drivers and ability to investigate and resolve complex claims
• Experience with athenaHealth and/or athenaOne preferred
• Experience with NJ payers and portals required
• Neurology AR experience required
• Advanced Microsoft Excel skills (e.g., pivot tables, VLOOKUP, sort/filtering, formulas) preferred
• Must comply with HIPAA rules and regulations

Pay

The hourly range for this role is $24/hr to $26.45/hr in base pay, exclusive of any bonuses or benefits. This role is 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.

Benefits

• Medical, dental, and vision insurance
• Life and pet insurance
• 401K
• Paid time off
• Wellness programs

Schedule

Technical requirements for remote workers: minimum 5 MBPS download speed and 3 MBPS upload speed. Employees working remotely may be eligible for expense reimbursement to offset internet costs.