This position  is a hybrid full-time role that requires in office on Tuesdays and Thursdays at 1200 Binz St Suite 1490 Houston TX 77004. Mon, Wed, and Fri are typically work from home but subject to change for internal meetings, trainings, and conferences.* Under the direction of the Manager of Revenue Cycle Management, the Medical Claims Specialist (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. The Medical Claims Specialist will take steps necessary to resolve all claim issues or questions that escalate to the RCM team. Resolution of SalesForce cases and management of issues and the team resolving the cases is a key element in this role.  Primary Job Duties: Denial management - investigating denial sources, resolving and appealing denials which may include contacting payer representatives Makes independent decisions regarding claim adjustments, resubmission, appeals, and other claim resolution techniques Collaborate with internal teams (Performance, Operations, Sales) as well as care center staff when appropriate Works closely with our Revenue Optimization team, to support efforts to ensure reimbursement is in line with payer contract agreements.  Work directly with practice consultants or physicians to ensure optimal revenue cycle functionality Drive toward achievement of department’s daily and monthly Key Performance Indicators (KPIs), requiring a team focused approach to attainment of these goals Other duties as assigned
Frequently Asked Questions
What does the Medical Claims Billing Specialist role at Privia Health involve?
The Medical Claims Billing Specialist position at Privia Health in Houston, us is a full-time role. This position&xa0; is a hybrid full-time role that requires in office on Tuesdays and Thursdays at 1200 Binz St Suite 1490 Houston TX 77004. Mon, Wed, and Fri are typically work from home but subject to change for internal meetings, trainings, and conferences. Under the direction of the Manager of Revenue Cycle Management, the&xa0;Medical Claims Specialist (AR&xa0;Manager)&xa0;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. The&xa0;Medical Claims Specialist&xa0;will take steps necessary to resolve all claim issues or questions that escalate to the RCM team.
What skills are required for Medical Claims Billing Specialist at Privia Health?
Key skills for this role include: Scala, Salesforce.
What is the salary for Medical Claims Billing Specialist at Privia Health?
The salary for this position is not publicly listed. You can negotiate during the interview process. Check Glassdoor or Levels.fyi for estimates.
Is the Medical Claims Billing Specialist position at Privia Health remote or on-site?
This position is Hybrid. Expect a combination of office and remote work, typically based in Houston, us.
How do I apply for Medical Claims Billing Specialist at Privia Health?
You can apply for this position directly through the employer's careers page. Click the 'Apply Now' button on this page to be redirected to the original listing. Make sure your resume is ATS-optimized. Use SpotChange's free ATS test to check.
Medical Claims Billing Specialist at Privia Health is a full-time other position in Houston, us. Key skills include Scala, Salesforce. Education: Master's Degree preferred. Experience: 3+ years.
This role is classified as hybrid and is suitable for mid level-level professionals. Ghost Score 5/100 (Fresh) indicates this listing is very likely active and recently refreshed.
To apply, visit the official application page through the Apply Now button above. SpotChange Jobs provides AI-powered career tools including resume optimization, ATS testing, interview preparation, and salary negotiation assistance.