Accounts Receivable & Case Management Specialist - Remote

Overview

The Accounts Receivable & Case Management Specialist at Privia Health is responsible for ensuring accurate and timely processing of claims, acting as a bridge between financial accuracy and effective communication to resolve insurance claim denials.

In Short

• Manage full cycle of Salesforce cases related to RCM inquiries.
• Monitor Salesforce dashboards to identify trends in inquiries.
• Deep expertise in billing, AR follow-up, and denial management.
• Make independent decisions on claim adjustments and resubmissions.
• Collaborate with internal teams to streamline workflows.
• Utilize Trizetto for denial analysis and prevent recurring errors.
• Work with practice consultants to ensure optimal revenue cycle functionality.
• Ensure compliance with HIPAA and company policies.
• Report on case resolution efficiency to leadership.
• Other duties as assigned.

Requirements

• High School Graduate.
• 3+ years in a medical billing office or equivalent claims experience.
• Advanced Microsoft Excel skills preferred.
• Experience with athenaHealth/athenaOne and Salesforce preferred.
• Strong understanding of credentialing and enrollment.
• Ability to resolve complex claim issues.
• Must comply with HIPAA regulations.

Benefits

• Medical, dental, vision, and life insurance.
• 401K plans.
• Paid time off.
• Wellness programs.
• Annual bonus targeted at 10%.