[Hiring] Senior Manager, Revenue Cycle @Privia Health

Role Description

Under the direction of the Sr. Director of Revenue Cycle Management, the Senior Manager, Revenue Cycle Management, is responsible for oversight and training of staff, management of functions and processes, and accountable for the team hitting performance, quality, and production metrics. The Sr. Manager will support RCM Associate Directors with escalations and larger strategic projects as needed.

The Sr. Manager is responsible for ensuring that the Accounts Receivables are worked in accordance with best practices and that all Manager Holds, Zero Pay, Unapplied, Unpostables, and other Aged Accounts Receivable are reviewed, reconciled, and resolved in a timely and compliant manner.

Additionally, the Sr. Manager will take steps necessary to resolve all claim issues or questions that escalate to the RCM team. Resolution of SalesForce cases and management of issues, as well as management of the team resolving the cases, is a key element in this role. We look for strong training and claims management skills along with a strict attention to detail, a solutions-focused mindset, and a driving work ethic.

Primary Job Duties:

• Oversee the entire claims submission and follow-up process, ensuring claims are submitted accurately and on time.
• Lead and manage large payer projects and care center support projects, updating leadership and affected stakeholders as needed.
• Keep ADs abreast of opportunities for improvement in daily operations along with recommendations on process improvements.
• Management of the teams accountable for the accounts receivable (AR) including analysis and resolution of the aged AR, looking for root cause issues.
• Utilize data to identify patterns in claim denials or delays and develop actionable solutions to address them.
• Independent decision making regarding claim adjustments, resubmission, appeals, and other claim resolution techniques.
• Makes policy updates as needed, to all RCM policies.
• Meets with the Performance Operations, Implementation, Sales, and other Privia teams to review escalated issues and discuss payer or claim concerns.
• Meets with Care Center leadership including the lead physician partners, office managers, and other staff to discuss complex claim or other revenue cycle matters.
• Responsible for training internal teams (Operations, Sales) as well as care center staff when appropriate.
• Support care center go-lives as needed, which may include overnight travel.
• Laser focused drive toward achievement of department’s daily and monthly KPIs, requiring a team-focused approach to attainment of these goals.
• Responsible for performing or assisting with duties related to staffing to include hiring, termination, coaching, and training.
• Provides ongoing feedback to subordinate staff regarding performance throughout the year.
• Counsels employees in disciplinary matters and obtains assistance from human resources appropriately for disciplinary actions and/or employee termination process.
• Other duties as assigned.

Qualifications

• High School Graduate, Medical Office training certificate or relevant experience.
• 5+ years experience in managing physician revenue cycle.
• 3+ years experience in management of personnel.
• Must understand the drivers of revenue cycle optimal performance and be able to investigate and resolve complex claims.
• Strong preference for experience working with athenaOne, Trizetto, and SalesForce.
• Must comply with HIPAA rules and regulations.

Requirements

• The salary range for this role is $75,000.00-$80,000.00 in base pay and exclusive of any bonuses or benefits (medical, dental, vision, life, and pet insurance, 401K, paid time off, and other wellness programs).
• This role is also eligible for an annual bonus targeted at 15% and restricted stock units.
• The base pay offered will be determined based on relevant factors such as experience, education, and geographic location.

Benefits

• All of your information will be kept confidential according to EEO guidelines.

Company Description

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.