[Hiring] Athena Systems & Enrollment Analyst @Privia Health

Role Description

The Athena Systems & Enrollment Analyst is a critical role responsible for identifying, analyzing, and resolving conflicts and inconsistencies across revenue cycle management (RCM) and provider credentialing and enrollment processes. This individual will focus on preventing revenue leakage by ensuring data integrity across all systems, validating system configurations, and driving cross-departmental process improvements.

• Under the direction of the Senior Manager, Athena Systems, completes all EFT, ERA, EDI set up and enrollment with all health plans through claims system or payor portal.
• Conducts regular follow up with all health plans to obtain statuses of provider submissions.
• Works with other Privia partners in addressing any provider enrollment issues.
• Identify and resolve revenue leakage through RCM data analysis.
• Ensure accuracy and consistency of provider and practice data across EHR, credentialing, and payer systems.
• Maintain and validate enrollment tables, matrices, and system configurations.
• Review and optimize EHR rules to prevent credentialing and billing-related claim denials.
• Collaborate cross-functionally to resolve data and workflow issues.
• Develop reports and dashboards to track KPIs and revenue impact.
• Document and share processes, system rules, and best practices.
• Supports special projects requiring knowledge of delegated and non-delegated health plan requirements.
• Coordinate and prepare reports.
• Record and track credentialing statistics.

Qualifications

• Bachelor's degree in Healthcare Administration, Finance, Business, or a related field, or equivalent work experience preferred.
• Must have Athena system knowledge.
• Knowledge of AthenaCollector payer enrollment table strongly preferred.
• At least 3 years experience in managed care credentialing, billing and/or Medical Staff service setting required.
• Accelerated skills in problem solving, analysis and attention to detail.
• Advanced Microsoft Excel/Google sheet skills.
• Must be able to function independently, possess demonstrated flexibility in multiple project management.
• Must comply with HIPAA rules and regulations.
• Prefer knowledge of EFT, ERA, EDI enrollment and claims systems.

Requirements

• The salary range for this role is $55,000.00 to $60,000.00 in base pay and exclusive of any bonus or benefits.
• This role is also eligible for an annual bonus targeted at 10%.
• The base pay offered will be determined based on relevant factors such as experience, education, and geographic location.

Benefits

• Medical, dental, vision, life, and pet insurance.
• 401K.
• Paid time off.
• Other wellness programs.