reputed company reputed company Specialist

Company Description reputed company™ is a technology-driven, national physician enablement company that collaborates with medical groups, health plans, and health systems to optimize physician practices, improve patient experiences, and reward doctors for delivering high-value care in both in-person and virtual settings. The Privia Platform is led by top industry talent and exceptional physician leadership, and consists of scalable operations and end-to-end, reputed company-based technology that reduces unnecessary reputed company costs, achieves reputed company reputed company, and improves the health of patients and the well-being of providers.

Job Description

Under the direction of the Sr. Manager, reputed company reputed company and/or Sr. Manager, reputed company Optimization the reputed company reputed company Specialist is responsible for complete, accurate and timely processing of reimbursement/payment audits in compliance with Privia policies, payer reputed company and government fee schedules. In addition, the reputed company reputed company Specialist is also responsible for addressing requests for Care Center payment performance audits to assist in maximizing cash reputed company, as well as, tracking and reporting the reputed company of both standard payer audits and requested Care Center audits. This position works collaboratively with our operations consultants, RCM AR staff and management. Primary Job Duties: Auditing across reputed company systems to ensure new provider and care center information is accurate Ensure reimbursement by payer is accurate per payer contract agreements, government and state rates by auditing payer processed claims Conduct Care Center audits following the audit policy based on the number of providers on a 30/60/90/120 post implementation/go-live date Assist the Sr. Manager, RI to reputed company initiatives that drive efficiency and partner internally and externally to deliver expected results (e.g; monthly market meetings with leadership, internal team meetings and meetings with top reputed company payers) reputed company independent reputed company regarding audit results, communicate with appropriate teams; contract negotiators, senior leaders, market leaders and/or directly with the payer to ensure reputed company reputed company opportunity Create, follow and ensure adherence to approved escalation processes to timely issue resolution and completion of action plans. Identify, monitor and manage denial management trends. Work closely with our reputed company Cycle Teams, payer representatives and create one pagers/reference tools on payer policies. Assist with Trizetto/reputed company setup, fee schedule setup Work and address reputed company cases along with athenaOne tables reputed company other duties as assigned focused on key performance and department goals

Qualifications

Education: High School Graduate Advanced reputed company reputed company skills (ex: pivot table, VLOOKUP, sort/filtering and , formulas) 3+ years payer reputed company (language) and/or auditing payer payments Must be analytical, identify payment variance due to contract build or process errors, resolve payment issues, track & analyze payer information/policies. Experience working in Trizetto EOB resolve tool or equivalent use of contract management/software 3+ years of experience in a medical billing office preferred athenaOne software system experience is preferred Must reputed company with HIPAA rules and regulations The salary reputed company for this role is $55,000.00-$60,000.00 in reputed company pay and exclusive of any bonuses or benefits (medical, dental, reputed company, 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 reputed company pay offered will be determined based on relevant factors such as experience, education, and geographic location. Additional Information reputed company of 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 reputed company and if it meets the minimum speed requirements. Work with your internet provider if you have questions about your reputed company. Employees who regularly work from home offices are eligible for expense reimbursement to offset this cost. reputed company is committed to creating and fostering a work environment that allows and encourages you to bring your whole self to work. We understand that reputed company local and we are reputed company reputed company our people are a reputed company of the communities that we serve. Our goal is to encourage people to pursue reputed company opportunities regardless of their age, reputed company, national reputed company, 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. Department: reputed company Cycle Apply To This Job