AR Representative (New Jersey, Neurology)
- Role
- Finance
- Experience
- Mid
- Employment
- Full-time
Open to US only. Set where you work from to check your eligibility.
No BS summary
This role is for an Accounts Receivable (AR) Representative with 3+ years of medical billing experience, specifically in Neurology AR and with NJ payers. The candidate will manage AR, investigate denials, and resolve complex claims. Experience with athenaHeath/athenaOne and advanced Excel skills are preferred.
Core skills
Required skills
Optional skills
Privia Health™ 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, cloud-based technology that reduces unnecessary healthcare costs, achieves better outcomes, and improves the health of patients and the well-being of providers.
Under the direction of the Associate Director of Revenue Cycle Management, the Accounts Receivable (AR) Manager is responsible for ensuring the accurate and timely processing of all assigned claims. This role includes promptly addressing daily correspondence from physician practices, reviewing and appealing insurance claim denials and following up on aged claims. The AR Manager will take the steps necessary to resolve all claim issues or questions that escalate to the RCM team to include Salesforce case management. Primary Job Duties: Management of the accounts receivable (AR) including analysis of the aged AR, looking for root cause issues; suggesting billed rules/edits when appropriate to stop errors from occurring Denial management - investigate denial sources, resolve and appeal denials which may include contacting payer representatives Make 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 Support large care center go lives when applicable Work closely with our Revenue Optimization team to support efforts to ensure reimbursement is in line with payer contract agreements. Perform denial analysis utilizing the Trizetto platform. 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) Other duties as assigned
High School Graduate 3+ years experience in a medical billing office or equivalent claims experience Must understand the drivers of revenue cycle optimal performance and be able to investigate and resolve complex claims Experience with athenaHeath and/or athenaOne preferred Experience with NJ payers and portals required Neurology AR experience required Advanced Microsoft Excel skills (ex: pivot tables, VLOOKUP, sort/filtering, formulas) preferred Must comply with HIPAA rules and regulations The hourly range for this role is $24/hr to $26.45/hr in hourly 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 10%. The base pay offered will be determined based on relevant factors such as experience, education, and geographic location.
All 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. This gives you an update as to how fast data transfer is with your internet connection and if it meets the minimum speed requirements. Work with your internet provider if you have questions about your connection. Employees who regularly work from home offices are eligible for expense reimbursement to offset this cost. Privia Health is committed to creating and fostering a work environment that allows and encourages you to bring your whole self to work. We understand that healthcare is local and we are better when our people are a reflection of the communities that we serve. Our goal is to encourage people to pursue all opportunities regardless of their age, color, national origin, 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.
What you'll do
- Management of the accounts receivable (AR) including analysis of the aged AR, looking for root cause issues; suggesting billed rules/edits when appropriate to stop errors from occurring
- Denial management - investigate denial sources, resolve and appeal denials which may include contacting payer representatives
- Make 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
- Support large care center go lives when applicable
- Work closely with our Revenue Optimization team to support efforts to ensure reimbursement is in line with payer contract agreements.
- Perform denial analysis utilizing the Trizetto platform.
- 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)
- Other duties as assigned
- Research and resolve ununmatched charges in and that have not been matched to athenaOne (`unpostables`) — insurance payments, capitation payments, patient payments, remittance items, voided charges.
- Reconcile re-adjudicated claims / payer takebacks.
- Make independent decisions on claims adjustments, resubmissions, appeals, and alternate resolution methods.
- Maintain payer web portal access for all payers and interfaces with athenaOne.
- Train internal teams (Operations, Sales) and care center staff.
- Work directly with practice consultants/physicians to ensure optimal revenue function in workflow.
- Drive team achievement of the department's daily and monthly key performance indicators.
- Ensure accurate and timely processing of all assigned claims.
- Promptly address daily correspondence from physician practices.
- Review and appeal insurance claim denials and follow up on aged claims.
- Manage accounts receivable (AR) including analysis of aged AR and root cause identification; suggest billed rules/edits when appropriate.
- Denial management — investigate denial sources, resolve and appeal denials which may include contacting payer representatives via phone.
- Make independent decisions regarding claim adjustments, resubmission, appeals, and other claim resolution techniques.
- Collaborate with internal teams (Performance, Operations, Sales) and care center staff when appropriate.
- Support large care center go-lives when applicable, which may include overnight travel.
- Work closely with the Revenue Optimization team to ensure reimbursement aligns with payer contract agreements.
- Work directly with practice consultants or physicians to ensure optimal revenue cycle functionality.
- Drive toward achievement of department daily and monthly Key Performance Indicators (KPIs).
- Other duties as assigned.
What they require
- High School Graduate
- 3+ years experience in a medical billing office or equivalent claims experience
- Must understand the drivers of revenue cycle optimal performance and be able to investigate and resolve complex claims
- Experience with NJ payers and portals required
- Neurology AR experience required
- Must comply with HIPAA rules and regulations
- Preferred: Experience with athenaHeath and/or athenaOne
- Preferred: Advanced Microsoft Excel skills (ex: pivot tables, VLOOKUP, sort/filtering, formulas)
- For remote workers only: minimum of 5 MBPS for Download Speed and 3 MBPS for the Upload Speed
- High school graduate.
- 3+ years experience in a medical billing office (or equivalent claims experience).
- Background in the double-loop.
- Understanding of revenue cycle drivers.
- Advanced Microsoft Excel skills (pivot tables, VLOOKUP, sort/filtering, formulas).
- Experience with athenaHealth / athenaOne preferred.
- Compliance with HIPAA rules and regulations.
- New Jersey provider and payer experience preferred.
- Independent decision maker with strong research skills
- Willingness to support go-lives which may include overnight travel
Benefits
- Medical insurance
- Dental insurance
- Vision insurance
- Life insurance
- Pet insurance
- 401K
- Paid time off
- Wellness programs
- Annual bonus targeted at 10%
- Expense reimbursement for employees who regularly work from home offices
- Hourly base pay $24/hr–$26.45/hr.
- Annual bonus targeted at 10%.
- Medical, dental, vision, life, and pet insurance.
- 401K.
- Paid time off and other wellness programs.
- Expense reimbursement to offset home-Internet costs for employees who work remotely.
- Base pay $24/hr - $26.45/hr
- Eligible for an annual bonus targeted at 10% based on performance
- Other wellness programs
- Expense reimbursement for home office internet for remote workers
Privia Health is a national physician organization that transforms the healthcare delivery experience for providers and consumers.