Claims Billing Specialist (Athena EMR)
New
P
Privia HealthHealthcare billing
Source API remote eligibility restrictions: United StatesFull-TimeMiddle
SalaryThe hourly range for this role is $24/hr - 26.45/ hr in base pay; annual bonus targeted at 10% based on performance in the role.
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Job Details
- Experience
- 3+ years experience in a medical billing office or equivalent claims experience
- Required Skills
- Microsoft ExcelGoogle SheetsHIPAA
Requirements
- High school graduate.
- Have 3+ years of experience in a medical billing office or equivalent claims experience.
- Understand the drivers of optimal revenue cycle performance.
- Be able to investigate and resolve complex claims.
- Comply with HIPAA rules and regulations.
- Bring independent decision-making and strong research skills.
- Advanced Microsoft Excel or Google Sheets skills, including pivot tables, VLOOKUP, sorting, filtering, and formulas, are preferred.
- Experience with athenaHealth and/or athenaOne is highly preferred.
- Experience working with New Jersey payers and providers is preferred.
Responsibilities
- Manage accounts receivable, analyze aged AR, identify root causes, and suggest billing rules or edits to prevent errors.
- Investigate denial sources, resolve and appeal denials, and contact payer representatives when needed.
- Make independent decisions on claim adjustments, resubmissions, appeals, and other claim-resolution techniques.
- Collaborate with Performance, Operations, Sales, and care center staff.
- Support large care center go-lives, which may include overnight travel.
- Perform denial analysis using the TriZetto platform and support reimbursement in line with payer contract agreements.
- Work with practice consultants or physicians to support revenue cycle functionality.
- Drive achievement of daily and monthly department KPIs.
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