Insurance Credit Resolution Specialist

Privia Health•Arlington, VA

8d•$25 - $26•Hybrid

About The Position

This role requires hybrid in-office work at our HQ office in Arlington, VA Under the direction of the Sr. Manager, Revenue Cycle Management, the Insurance Credit Resolution Specialist is responsible for complete, accurate and timely processing of all assigned insurance related credits. Processing of these credits includes reviewing and responding to daily correspondence from physician practices in a timely manner, answering incoming inquiries, preparing insurance refund checks for mailing, and processing returned checks. Implement payer specific workflows for void requests, take back requests and insurance refund initiations Research and resolve overpaid and denied claims in athenaNet Use Salesforce to manage worklists and requests/inquiries from Care Centers Successfully process 35+ insurance refunds daily In office specific duties: Utilize athenaNet software to identify and print appropriate insurance refund letters Enter insurance refund check #s into athenaNet for tracking In the absence of a payer refund letter, use letter template to make custom refund letters Prepare checks to be mailed including matching checks with refund letter, folding, inserting, addressing and sealing envelopes Sorting checks by payer Retrieve and process returned checks accordingly Other duties as needed

Requirements

High School Graduate, Medical Office training certificate or relevant experience
3+ years experience in physician revenue cycle / claims management
Background with posting charges, claim follow up, collections, and payment posting
Must have experience working with athenahealth’s suite of tools
Must comply with HIPAA rules and regulations

Responsibilities

Implement payer specific workflows for void requests, take back requests and insurance refund initiations
Research and resolve overpaid and denied claims in athenaNet
Use Salesforce to manage worklists and requests/inquiries from Care Centers
Successfully process 35+ insurance refunds daily
Utilize athenaNet software to identify and print appropriate insurance refund letters
Enter insurance refund check #s into athenaNet for tracking
In the absence of a payer refund letter, use letter template to make custom refund letters
Prepare checks to be mailed including matching checks with refund letter, folding, inserting, addressing and sealing envelopes
Sorting checks by payer
Retrieve and process returned checks accordingly
Other duties as needed