RCM Systems Specialist (Athena)

Privia Health

9d•$60,000 - $65,000•Remote

About The Position

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 Senior Manager, Revenue Optimization the Revenue Optimization & Systems Specialist is responsible for the maintenance and accuracy of the medical group’s chargemaster and fee schedules, answers support requests from internal stakeholders and physician partners, and supports the successful configuration of RCM systems for newly onboarded provider groups.

Requirements

High School Graduate
Medical billing (CPT/HCPCs) experience preferred
Experience with athenaHeath and/or athenaOne required
Must comply with HIPAA rules and regulations
Advanced analytical skills, including Microsoft Excel skills (ex: pivot tables, VLOOKUP, sort/filtering, formulas)
Experience using Salesforce for case management preferred

Responsibilities

Process and implement requested edits or updates to the medical chargemaster/fee schedules within a defined service level agreement (SLA).
Evaluate and process requests for changes to the service pricing by following established best-practice policies for approval or denial.
Act as the internal subject matter expert, collaborating with clinical and operations teams to ensure compliance with payer guidelines and governmental regulations.
Execute and manage annual projects specifically for updating and incorporating the new flu season CPT/HCPCS codes.
Support the development and implementation of new market chargemasters in direct collaboration with the implementation project leader.
Manage, investigate, and respond to incoming inquiries and issues reported through the Salesforce case management system.
Implement and ensure standardization of policies across all markets
Maintain a focused effort toward meeting and exceeding the department’s daily and monthly Key Performance Indicators (KPIs).
Develop expertise in managing and configuring tablespace-wide settings within the athenaOne and all relevant systems.
Design, test, and implement rule edits within the athenaOne EHR system.
Execute complete tablespace builds and configurations for onboarding new provider groups.