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Revenue Specialist
Revenue Cycle Management
Remote - US
Full Time

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Title/Position: Revenue Specialist

Department or Business Unit: RCM

Reporting Structure: Manager, RCM

Employment Type: FTE

Exemption Status: Non-Exempt

Min. Experience: Entry/Mid Level

Travel Required: None

**Preference is EST or CST time zone

Overview of the Role:


The Revenue Specialist is responsible for complete, accurate and timely processing of all designated claims, including legacy AR, reviewing and responding to daily correspondence from physician practices in a timely manner, answering incoming telephone calls and providing information as requested or properly authorized. We look for strong follow up skills, attention to detail; a solutions-focused mindset, and a driving work ethic. This position works collaboratively with the staff in our physician practices as well as team members at Privia Headquarters.


Primary Job Duties:


  • Work directly with payers, payer reps and providers to resolve complex claim denials 
  • Denial management - investigating denial sources, resolving and appealing denials which may include contacting payer representatives.
  • Analyze payer trends
  • Understand and work with revenue cycle from point of scheduling to processing of claims
  • Processing patient and insurance refunds
  • Accurate and timely processing of all designated claims


Minimum Qualifications:


  • High School Graduate, Medical Office training certificate or relevant experience
  • 3+ years experience in medical billing office.
  • Experience in a multi-specialty billing environment is a plus
  • Strong preference for experience working with athenaHealth’s suite of tools 
  • Must comply with all HIPAA rules and regulations

Physical Demands:


The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. While performing the duties of this job, the employee is occasionally required to stand; walk; sit; use hands to finger, handle, or feel objects, tools or controls; reach with hands and arms; climb stairs; balance; stoop, kneel, crouch or crawl; talk or hear.


Technical Requirements for Remote Work:

In order to successfully work remotely, supporting our patients and providers, we require a minimum of 5 MBPS for Download Speed and 3 MBPS for the Upload Speed. This should be acquired prior to the start of your employment. The best measure of your internet speed is to use online speed tests like https://www.bing.com/search?q=speedtest . This gives you an update as to how fast data transfer is with your internet connection and if it meets the minimum speed requirements. Work with your internet provider if you have questions about your connection. Employees who regularly work from home offices are eligible for expense reimbursement to offset this cost.

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