Manager, Revenue Cycle

Privia Health•Houston, TX

1d•Hybrid

About The Position

Privia Health is seeking a Manager, Revenue Cycle Management, to oversee revenue cycle staff, functions, and processes and ensure the team meets performance, quality, and production metrics. Reporting under the direction of an Associate Director, Director, or AVP of Revenue Cycle Management, the manager supports Gulf Coast Market RCM Associate Directors with escalations and strategic projects. The role ensures accounts receivable are handled according to best practices and that Manager Holds, Zero Pay, Unapplied, Unpostables, and other aged accounts receivable are reviewed, reconciled, and resolved in a timely, compliant manner. The manager also resolves escalated claim issues and oversees Salesforce cases and the team working those cases. This is a full-time hybrid role based at 1200 Binz St, Suite 1490, Houston, Texas. Office attendance is required Tuesdays and Thursdays; Mondays, Wednesdays, and Fridays are typically work from home, with occasional office attendance possible. Remote workers must have internet speeds of at least 5 Mbps download and 3 Mbps upload. Employees who regularly work from home offices are eligible for expense reimbursement to offset this cost. The position requires strong training and claims management skills, attention to detail, a solutions-focused mindset, and a strong work ethic. The manager works with internal teams and care center leadership on escalated issues, payer and claim concerns, and complex revenue cycle matters, while driving daily and monthly KPI achievement.

Requirements

High school graduate, medical office training certificate, or relevant experience.
At least 5 years of experience managing physician revenue cycle.
At least 2 years of personnel management experience.
Understand the drivers of optimal revenue cycle performance and be able to investigate and resolve complex claims.
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, resolved, and submitted on time.
Lead large payer projects and care center support projects, updating leadership and affected stakeholders as needed.
Keep Associate Directors and the AVP informed about 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 techniques.
Update RCM policies as needed.
Meet with Performance Operations, Implementation, Sales, and other Privia teams to review escalated issues and discuss payer or claim concerns.
Meet with care center leadership, including lead physician partners, office managers, and other staff, to discuss complex claims and revenue cycle matters.
Drive team-focused achievement of department daily and monthly KPIs.
Identify workflow gaps and create training programs to address them.
Perform or assist with staffing duties, including hiring, termination, coaching, and training.
Provide ongoing performance feedback to staff throughout the year.
Counsel employees on disciplinary matters and involve Human Resources appropriately in disciplinary actions or termination processes.
Lead or co-present at meetings such as Office Manager Summits, Provider POD Meetings, and Market Retreats.
Perform other duties as assigned.