Sr. Manager, Revenue Cycle

About the role

The Senior Manager, Revenue Cycle Management oversees the claims submission and follow-up process, manages large payer projects and care center support projects, and ensures claims are submitted accurately and on time. They also manage the team's accounts receivable, analyze and resolve aged accounts receivable, and make policy updates as needed.

Responsibilities

• Oversee the entire claims submission and follow-up process, ensuring claims are submitted accurately and on time
• Lead and manage large payer projects and care center support projects, updating leadership and affected stakeholders as needed
• Keep ADs abreast of opportunities for improvement in daily operations along with recommendations on process improvements
• Manage the teams accountable for the accounts receivable (AR) including analysis and resolution of the aged AR, looking for root cause issues
• Utilize data to identify patterns in claim denials or delays and develop actionable solutions to address them
• Independent decision making - regarding claim adjustments, resubmission, appeals, and other claim resolution techniques
• Makes policy updates as needed, to all RCM policies
• Meets with the Performance Operations, Implementation, Sales and other Privia teams, review escalated issues and discuss payer or claim concerns
• Meets with Care Center leadership including the lead physician partners, office managers and other staff to discuss complex claim or other revenue cycle matters
• Support care center go lives as needed, which may include overnight travel
• Laser focused drive toward achievement of department’s daily and monthly KPIs, requiring a team focused approach to attainment of these goals
• Responsible for performing or assisting with duties related to staffing to include hiring, termination, coaching and training
• Provides ongoing feedback to subordinate staff regarding of performance throughout the year to subordinate staff
• Counsels employees in disciplinary matters and obtains assistance from human resources appropriately for disciplinary actions and/or employee termination process
• Other duties as assigned

Requirements

• High School Graduate, Medical Office training certificate or relevant experience
• 5+ years experience in managing physician revenue cycle
• 3+ years experience in management of personnel
• Must understand the drivers of revenue cycle optimal performance and be able to investigate and resolve complex claims
• CT and/or OH payer and provider experience preferred
• Strong preference for experience working with athenaOne, Trizetto and Salesforce
• Must comply with HIPAA rules and regulations

Qualifications

• Strong training and claims management skills along with a strict attention to detail, a solutions focused mindset, and a driving work ethic

Skills

• Strong training and claims management skills
• A strict attention to detail
• A solutions focused mindset
• A driving work ethic

Benefits

Privia Health offers a competitive compensation package including a salary range of $75,000.00-$80,000.00 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 15% and restricted stock units. The base pay offered will be determined based on relevant factors such as experience, education, and geographic location.

Pay

$75,000.00-$80,000.00 in base pay

Schedule

Remote work is available