Full-Time Sr. Manager, Revenue Cycle Management

This is a remote role seeking candidates located in the state of Florida. Under the direction of the VP 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.

In addition, 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.

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, 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.

Requirements: 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. Experience with Florida providers and payers preferred.

Must comply with HIPAA rules and regulations

Salary Range: $75,000 to $80,000 in base pay. Bonus and benefits (medical, dental, vision, life, and pet insurance, 401K, paid time off, and other wellness programs) are also offered. Eligible for an annual bonus targeted at 15% based on role performance and restricted stock units.

Base pay will be determined based on experience, education, and geographic location.

All information is confidential according to EEO guidelines.

Technical Requirements (for remote workers only): 5 MBPS Download Speed and 3 MBPS Upload Speed. Use online speed tests like https://www.speedtest.net/ to verify. Eligible for expense reimbursement to offset internet costs.

Equal Opportunity Employer: Privia Health fosters a work environment that encourages inclusion regardless of 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.

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