Unpostables Medical Claims Biller

Privia Health

1d•$24 - $26•Remote

About The Position

Under the direction of the Manager, Unpostables of Revenue Cycle Management, the Accounts Receivable (AR) Manager - Unpostables is responsible for overseeing the unpostables process within the RCM National Team. They identify, research and resolve unapplied cash, unidentified payments, and other discrepancies in patient accounts. The AR Manager - Unpostables ensures timely resolution of unpostable records, maintaining accurate records, and collaborating with other departments to improve processes and minimize unpostable occurrences. This role will also be responsible for taking the steps necessary to resolve all issues or questions that escalate to the unpostables team to include SalesForce case management.

Requirements

High School Graduate
3+ years experience in a medical billing office or equivalent claims experience
Must understand the drivers of revenue cycle optimal performance and be able to investigate and resolve complex claims
Advanced Microsoft Excel skills (ex: pivot tables, VLOOKUP, sort/filtering, formulas)
Must comply with HIPAA rules and regulations

Nice To Haves

Experience with athenaHeath and/or athenaOne preferred

Responsibilities

Unpostables management that includes researching and resolving records that have not been matched to athenaOne related charges (including insurance payments, capitation payments, patient payments, remittance items and voided charges)
Reconciliation of re-adjudicated claims/payer takebacks
Make independent decisions regarding claim adjustments, resubmission, appeals, and other claim resolution techniques as needed
Maintain payer web portal access for all payers and interfaces with athenaOne
Responsible for training internal teams (Operations, Sales) as well as care center staff when appropriate.
Work directly with practice consultants or physicians to ensure optimal revenue cycle functionality
Drive toward achievement of department’s daily and monthly Key Performance Indicators (KPIs)
Other duties as assigned