Coding and Billing Specialist (Medical Group)

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.

Job Description

The Coding and Billing Specialist (Care Center Biller) is responsible for complete, accurate and timely processing of all designated claims, reviewing and responding to daily correspondence from physician practices in a timely manner, and providing information as requested or properly authorized. This person has 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 physicians and practice administrators on a daily basis to ensure optimal revenue cycle functionality
• Understand and explain various health plan options and requirements
• Understand and work with revenue cycle from point of scheduling to processing of claims
• Work back end edits and denials and submit corrected claims and appeals
• Create claims and work front-end edits and denials in EHR system
• Review provider documentation and code for services as necessary to ensure proper charge capture, following all payer and coding guidelines, including those set forth by the AMA in the CPT, ICD-10, and HCPCS code books, CMS, and other regulatory bodies
• Query providers as necessary regarding any questions that may arise in relation to the documentation provided
• Work with other team members to ensure that all of the team’s assigned work is completed correctly and in a timely manner, helping other team members as needed

Qualifications

• Education: High School Graduate
• Experience: 3+ years experience in a medical billing office
• Charge entry experience required
• Preference for experience with athenaHealth’s suite of tools
• Strong preference for coding experience and knowledge of CCI edits
• CPC or CPC-A preferred
• Must comply with all HIPAA rules and regulations

Interpersonal skills & attributes

• Excellent written and verbal communication
• Willingness to train and mentor other team members
• Great time management skills
• Excellent critical thinking skills
• Ability to work independently and multi-task in a fast paced environment
• Technically capable and savvy

The salary range for this role is $40,000-43,000.00 in base pay and exclusive of any bonuses 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.

Additional Information

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

Technical Requirements (for remote workers only, not applicable for onsite/in office 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.speedtest.net/. 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.

Privia Health is committed to creating and fostering a work environment that allows and encourages you to bring your whole self to work. Privia is a better company when our people are a reflection of the communities that we serve. Our goal is to encourage people to pursue all opportunities regardless of their age, color, national origin, physical or mental (dis)ability, race, religion, gender, sex, gender identity and/or expression, marital status, veteran status, or any other characteristic protected by federal, state or local law.