Sr. Manager, Privia+

Privia Health

4h•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. The Senior Manager, Privia+ oversees the BILLER+ and CODER+ offerings under the Privia+ brand and will report to the Director, Privia+. This person is accountable for the success of these programs and manages the day-to-day operations for a growing customer base. This includes, but is not limited to, creating and maintaining SOP (Standard Operating Procedure) documentation, ensuring compliance at every step in the process, providing direction to a cross-functional team, and holding team members and vendor partners accountable to meet SLAs and performance expectations. The ideal candidate has operational and project management skills, experience managing a global workforce, and deep subject matter knowledge of physician revenue cycle, physician professional coding (Pro-Fee) and physician practice workflows in a multi-specialty physician practice environment.

Requirements

Certified Professional Coder (CPC) required with a minimum of 5+ years of experience in Evaluation & Management Coding and various specialties
Minimum of 5+ years of demonstrated knowledge and expertise of physician revenue cycle, physician professional coding, and physician professional billing and practice workflows
Minimum of 3+ years experience managing a global revenue cycle team of direct reports (billers and coders) and vendor partners
Ability to work effectively with clinicians and staff to implement change
Strong analytical, reporting and project management skills
Strong denial management experience
Strong knowledge of E/M (Evaluation & Management) coding and Value Based Care Coding
Must comply with HIPAA rules and regulations

Nice To Haves

Certified Professional Biller (CPB) preferred
Coding Auditing experience preferred
Experience with athenahealth PMS/EHR preferred
Experience with multi-specialty service lines and coding/billing preferred

Responsibilities

Responsible for BILLER+ and CODER+, including (Pro-Fee) and physician practice workflows in a multi-specialty physician practice environment
Manage a global workforce of employed staff and vendor contracted billing and coding teams to ensure delivery on production targets, turnaround times, quality, and other SLAs
Lead a team of billing and coding professionals, providing coaching, support, and mentorship
Responsible for the delivery of up to date and compliant provider educational materials, including but not limited to, relevant sources and/or payer policies
Collaborate and develop Standard Operating Procedures (SOPs) regarding coding and billing operations, escalations, team alignment, and vendor/client facing materials
Serve as the primary escalation point for addressing coding and billing operational and performance issues with vendors, partner organizations, and internal staff
Work closely with Director to identify best practices to maximize accuracy, efficiency, and effectiveness of coding support services to providers
Partner with Implementation to ensure successful customer go-lives, for large or complex customer implementations, and ensure proper system setup
Partner with customer success to support complex customers as it relates to all coding and billing operations
Provide updates and reporting on key performance metrics to leadership
Identify and/or collaborate with RCM leadership on opportunities to improve the programs through workflow, technology and/or partnerships
Research and resolve identified issues/questions from clients/internal stakeholders
Occasional Manage salesforce cases and ensure they are being addressed timely by assigned staff
Perform other duties as assigned