RCM Systems Specialist (Athena)

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

Under the direction of the Senior Manager, Revenue Optimization the Revenue Optimization & Systems Specialist is responsible for the maintenance and accuracy of the medical group’s chargemaster and fee schedules, answers support requests from internal stakeholders and physician partners, and supports the successful configuration of RCM systems for newly onboarded provider groups.

Chargemaster Management

• Respond in a timely manner to requests for edits or updates to the medical chargemaster
• Follow best practice policies for approving or denying requests
• Become an internal expert on chargemaster best practices to ensure compliance with governmental regulations and payer guidelines. Work collaboratively with operations and clinical departments to ensure rules are followed.
• Manage annual projects for flu season and new codes
• Support the build of new market chargemasters in collaboration with implementation project leader

Issue Management

• Triage, research, and reply to various inbound requests through Salesforce case management
• Ensure consistent delivery of revenue optimization policy across multiple medical groups
• Laser-focused drive toward the achievement of the department’s daily and monthly KPIs

Data Maintenance & Standardization

• Become an expert on tablespace-wide athenaOne settings
• Create, test and maintain rule edits within athenaOne
• Complete tablespace builds for new provider groups

• High School Graduate
• Medical billing (CPT/HCPCs) experience preferred
• Experience with athenaHeath and/or athenaOne required
• Must comply with HIPAA rules and regulations
• Advanced analytical skills, including Microsoft Excel skills (ex: pivot tables, VLOOKUP, sort/filtering, formulas)
• Experience using Salesforce for case management preferred

The salary range for this role is $60,000.00-$65,000.00 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 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.