AR与Salesforce案例代表(弗吉尼亚)
AR & Salesforce Case Representative (Virginia)
Privia Health™ 是一家以技术驱动的全国性医生赋能公司,与医疗集团、健康计划和医疗系统合作,优化医生实践,改善患者体验,并在面对面和虚拟环境中为提供高价值护理的医生提供奖励。Privia 平台由行业顶尖人才和卓越的医生领导团队打造,包含可扩展的运营和端对端的基于云的技术,减少不必要的医疗成本,实现更好的结果,改善患者的健康状况和医护人员的福祉。
AR 管理员负责所有指定索赔的完整、准确和及时处理,及时审查和回应来自医生实践的每日通信,回答 Salesforce 案件并按要求或授权提供信息。AR 管理员将采取必要措施解决所有升级到 RCM 团队的索赔问题或疑问。解决 Salesforce 案件和管理问题以及团队解决案例如本职位的关键要素。此外,高级 AR 管理员需根据合规最佳实践监督应收账款 (AR) 中的功能,如索赔工作列表、零支付、未应用和拒付,确保所有内容都能及时审查、对账和解决。高级 AR 管理员还将作为我们内部子团队之一的专家和问题升级点。
· 管理应收账款 (AR),包括分析逾期应收账款,查找根本原因问题;在适当情况下编写规则以防止错误发生。
· 拒付管理 - 调查拒付来源,解决和上诉拒付,可能包括联系保险公司代表。
· 独立决定索赔调整、重新提交、上诉和其他索赔解决技术。
· 作为问题升级点,将问题升级至相关方。
· 根据需要提出并执行政策更新。
· 直接与实践顾问和/或医生通过 Salesforce 协作,确保最优的收入周期功能。
· 聚焦于推动部门日常和月度关键绩效指标 (KPI) 的实现,需要团队协作以达成这些目标。
· 其他指派的任务
- 高中毕业
- 5 年以上医生医疗账单经验
查看英文原文
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.
The AR Manager 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, answering incoming SalesForce cases and providing information as requested or properly authorized. The AR 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 and the team resolving the cases is a key element in this role. Additionally, the Senior AR Manager is responsible for overseeing functions within Accounts Receivable in accordance with compliant best practices, such as Claims Worklists, Zero Pay, Unapplied, and Denials, to ensure that all are reviewed, reconciled and resolved in a timely matter. The Senior AR Manager will also serve as an subject matter expert and point of escalation on one of our internal sub-teams.
· Management of the accounts receivable (AR) including analysis of the aged AR, looking for root cause issues; writing rules where appropriate to stop errors from occurring.
· Denial management - investigating denial sources, resolving and appealing denials which may include contacting payer representatives.
· Makes independent decisions regarding claim adjustments, resubmission, appeals, and other claim resolution techniques.
· Serves as an escalation point, and escalates issues to the appropriate party.
· Suggest and run point on policy updates as needed.
· Work directly with practice consultants and/or physicians via Salesforce to ensure optimal revenue cycle functionality
· Focused on driving toward achievement of department’s daily and monthly Key Performance Indicators (KPIs), requiring a team focused approach to attainment of these goals.
· Other duties as assigned
- High School Graduate.
- 5+ years experience in a physician medical billing office or equivalent claims experience
- Must understand the drivers of revenue cycle optimal performance and be able to investigate and resolve complex claims
- Microsoft Excel skills (ex: pivot tables, VLOOKUP, sort/filtering, formulas) preferred
- Experience working with athenaOne preferred
- Experience using Salesforce for case management preferred
- Must provide accessibility to private, quiet work space with high-speed internet to effectively work remotely (if a remote worker)
- Experience with VA payers & providers preferred
- Must comply with HIPAA rules and regulations
- Excellent written and verbal communication
- The hourly range for this role is $23/hr to $26/hr in hourly 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 10%. The base pay offered will be determined based on relevant factors such as experience, education, and geographic location.
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. 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 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.