Insurance Credit Resolution Specialist

About the role

This role requires hybrid in-office work at our HQ office in Arlington, VA.

Responsibilities

• Review and respond to daily correspondence from physician practices in a timely manner
• Answer incoming inquiries
• Prepare insurance refund checks for mailing
• Process returned checks
• Implement payer specific workflows for void requests, take back requests and insurance refund initiations
• Research and resolve overpaid and denied claims in athenaNet
• Manage worklists and requests/inquiries from Care Centers using Salesforce
• Successfully process 35+ insurance refunds daily
• In office specific duties:
• Utilize athenaNet software to identify and print appropriate insurance refund letters
• Enter insurance refund check #s into athenaNet for tracking
• Absent payer refund letter, use letter template to make custom refund letters
• Prepare checks to be mailed including matching checks with refund letter, folding, inserting, addressing and sealing envelopes
• Sorting checks by payer
• Retrieve and process returned checks accordingly

Requirements

• Education: High School Graduate, Medical Office training certificate or relevant experience
• 3+ years experience in physician revenue cycle / claims management
• Background with posting charges, claim follow up, collections, and payment posting
• AthenaOne EMR experience preferred
• Must comply with HIPAA rules and regulations

Qualifications

• Must comply with HIPAA rules and regulations

Skills

• Strong communication skills
• Attention to detail
• Experience with athenaNet and Salesforce

Benefits

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.

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 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.
• 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.