AR Representative (Virginia)

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.

About the role

The 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. This role involves resolving claim issues or questions escalated to the RCM team, managing SalesForce cases, and overseeing Accounts Receivable functions such as Claims Worklists, Zero Pay, Unapplied, and Denials to ensure timely resolution.

The Senior AR Manager serves as a subject matter expert and escalation point for internal sub-teams, analyzes aged AR for root cause issues, writes rules to prevent errors, and manages denial resolution, including appeals and payer communications. This role requires independent decision-making regarding claim adjustments, resubmissions, and appeals, as well as collaboration with practice consultants and physicians via SalesForce to optimize revenue cycle functionality.

Focused on achieving departmental Key Performance Indicators (KPIs) through a team-oriented approach, the AR Manager also suggests and implements policy updates as needed and performs other duties as assigned.

Responsibilities

• Process all designated claims accurately and timely.
• Review and respond to daily correspondence from physician practices.
• Manage and resolve incoming SalesForce cases.
• Resolve escalated claim issues or questions for the RCM team.
• Oversee Accounts Receivable functions, including Claims Worklists, Zero Pay, Unapplied, and Denials.
• Serve as a subject matter expert and escalation point for internal sub-teams.
• Analyze aged AR to identify root cause issues and write rules to prevent errors.
• Investigate denial sources, resolve and appeal denials, including contacting payer representatives.
• Make independent decisions on claim adjustments, resubmissions, appeals, and other resolution techniques.
• Escalate issues to appropriate parties as needed.
• Suggest and implement policy updates.
• Collaborate with practice consultants and physicians via SalesForce to ensure optimal revenue cycle functionality.
• Drive achievement of departmental daily and monthly KPIs through a team-focused approach.

Requirements

• High School Graduate.
• 5+ years of experience in a physician medical billing office or equivalent claims experience.
• Understanding of revenue cycle performance drivers and ability to investigate and resolve complex claims.
• Microsoft Excel skills (e.g., pivot tables, VLOOKUP, sort/filtering, formulas) preferred.
• Experience with athenaOne suite of tools preferred.
• Experience using SalesForce for case management preferred.
• Must comply with HIPAA rules and regulations.
• Excellent written and verbal communication skills.

Qualifications

• Experience with VA payers & providers preferred.
• Must provide accessibility to a private, quiet workspace with high-speed internet for remote work.

Pay

The hourly range for this role is $23/hr to $26/hr in base pay, exclusive of 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 retirement plan.
• Paid time off.
• Other wellness programs.

Technical Requirements

For remote workers, a minimum internet speed of 5 MBPS for download and 3 MBPS for upload is required. Employees working remotely are eligible for expense reimbursement to offset internet costs. Verify your internet speed using online tools like Speedtest.net.