Manager, Revenue Cycle

Privia Health•Houston, TX

10d•$70,000 - $72,000•Hybrid

About The Position

Privia Health is hiring a full-time Manager, Revenue Cycle in a hybrid role based in Houston, Texas. The position requires working in the office on Tuesdays and Thursdays, with Mondays, Wednesdays, and Fridays typically worked from home; occasional additional office attendance may be needed. Under the direction of the Associate Director, Director, or AVP of Revenue Cycle Management, the role oversees and trains staff, manages revenue cycle functions and processes, and is accountable for team performance, quality, and production metrics. The manager also supports Gulf Coast Market RCM Associate Directors with escalations and strategic projects. The role oversees accounts receivable work and ensures aged accounts and specified account categories are reviewed, reconciled, and resolved promptly and compliantly. It also manages escalated claim issues and Salesforce cases, including the team responsible for resolving them. The position calls for strong training and claims-management skills, close attention to detail, a solutions-focused approach, and a strong work ethic. The manager collaborates with internal teams and care center leaders, identifies operational improvements, develops training to address workflow gaps, and contributes to staffing and employee performance management.

Requirements

High school graduate, Medical Office training certificate, or relevant experience.
At least 5 years of experience managing physician revenue cycle operations.
At least 2 years of experience managing personnel.
Understanding of the drivers of optimal revenue cycle performance and ability to investigate and resolve complex claims.
Ability to comply with HIPAA rules and regulations.

Nice To Haves

Experience working with athenaOne, Trizetto, and Salesforce is strongly preferred.

Responsibilities

Oversee the claims submission and follow-up process, ensuring claims are accurately worked, submitted, and resolved on time.
Lead and manage large payer and care center support projects, providing updates to leadership and affected stakeholders.
Inform Associate Directors and the AVP of operational improvement opportunities and recommend process improvements.
Manage teams responsible for accounts receivable, analyze and resolve aged AR, and investigate root causes.
Use data to identify patterns in claim denials or delays and develop actionable solutions.
Make independent decisions regarding claim adjustments, resubmissions, appeals, and other claim-resolution methods.
Update RCM policies as needed.
Meet with Performance Operations, Implementation, Sales, and other Privia teams to review escalations and discuss payer or claim concerns.
Meet with care center leadership, including lead physician partners, office managers, and staff, to address complex claims and other revenue cycle matters.
Drive the team’s achievement of daily and monthly KPIs.
Identify workflow gaps and create training programs to address them.
Assist with staffing responsibilities, including hiring, termination, coaching, and training.
Provide ongoing performance feedback to staff throughout the year.
Counsel employees on disciplinary matters and coordinate with Human Resources as appropriate for disciplinary actions or terminations.
Lead or co-present at meetings such as Office Manager Summits, Provider POD Meetings, and Market Retreats.
Perform other duties as assigned.