Company Overview 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. Job Description This role requires hybrid in-office work at our HQ office in Arlington, VA. Under the direction of the Sr. Manager, Revenue Cycle Management, the Insurance Credit Resolution Specialist is responsible for complete, accurate and timely processing of all assigned insurance related credits. It includes reviewing and responding to daily correspondence from physician practices, answering incoming inquiries, preparing insurance refund checks for mailing, and processing returned checks. Implement payer specific workflows for void requests, take back requests, and insurance refund initiations. Research and resolve overpaid and denied claims in athenaNet. Use Salesforce to manage worklists and requests/inquiries from Care Centers. Successfully process 35+ insurance refunds daily. In-Office Duties Utilize athenaNet software to identify and print appropriate insurance refund letters. Enter insurance refund check numbers into athenaNet for tracking. Assist with sorting and processing incoming RCM mail, and streamline high-volume mail workflows. Create custom refund letters when a payer refund letter is not available. Prepare checks for mailing, including matching checks with refund letters, folding, inserting, addressing, and sealing envelopes. Sort checks by payer. Retrieve and process returned checks accordingly. Perform other duties as needed. Qualifications Education: High School Graduate with Medical Office training certificate or relevant experience. 3+ years of experience in physician revenue cycle/claims management. Background with posting charges, claim follow‑up, collections, and payment posting. AthenaOne EMR experience preferred. Must comply with HIPAA rules and regulations. Compensation The hourly range for this role is $25.00–$26.45 in base pay, exclusive of any bonuses or benefits (medical, dental, vision, life, pet insurance, 401K, paid time off, and other wellness programs). 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. EEO Statement All your information will be kept confidential according to EEO guidelines. Privia Health is committed to creating and fostering a work environment that allows and encourages you to bring your whole self to work. We understand that healthcare is local and we are better when our people are a reflection of the communities that we serve. Our goal is to encourage people to pursue all opportunities regardless of age, color, national origin, physical or mental (dis)ability, race, religion, gender, sex, gender identity and expression, marital status, veteran status, or any other characteristic protected by federal, state or local law. #J-18808-Ljbffr
Insurance Credit Resolution Specialist • Arlington, VA, United States
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