Director, Billing & Coding (CPC required)

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 Director, Privia+ provides leadership and direction for aasigned areas of the Privia+ marketplace. This person collaborates and is responsible for the success of the coding, billing, education, and quality components of the program. The Associate Director is an experienced leader who enjoys mentoring their direct reports as well as collaborating cross-functionally with Revenue Cycle, Coding and Compliance, Clinical, Implementation, Customer Success, and Technology teams. The Associate Director of Privia+ is a key collaborator on the strategic and operational direction of the team.

Minimum Requirements

• Responsible for overall programmatic success of BILLER+ and CODER+, including (Pro-Fee) and physician practice workflows in a multi-specialty physician practice environment.
• Responsible for overall programmatic success of BILLER+ and CODER+, including vendor partnerships, operational performance, client satisfaction, and quality
• Responsible for ensuring the global workforce, of employed staff and vendor contracted billing and coding teams, are delivering on production targets, turnaround times, quality, and other SLAs
• Lead a team of billing and coding professionals, providing coaching, support, and mentorship
• Develop, review, and approve all Standard Operating Procedures (SOPs) regarding coding and billing operations, escalations, team alignment and/ or vendor/client educational materials.
• Work closely with leadership to identify best practices to maximize accuracy, efficiency, and effectiveness of coding support services to providers
• Collaborate with Implementation, as needed, to ensure successful customer go-lives, for large or complex customer implementations, and ensure proper system setup
• Partner with customer success to support complex customers as it relates to all coding and billing operations
• Provide updates and reporting on key performance metrics to leadership
• Regularly communicate program updates, new features, and other important information to customers and internal stakeholders
• Solicit feedback from customers on opportunities to improve or enhance programs
• Identify and/or collaborate with RCM leadership on opportunities to improve the programs through workflow, technology and/or partnerships
• Identify and collaborate with Compliance leadership to address needs of the program as needed
• Research and resolve identified issues/questions from clients/internal stakeholders
• Work closely with Priva+ teams to ensure salesforce cases are being addressed timely by assigned staff
• Provides data to leadership on the turnaround time and quality assurance of salesforce service replies
• Minimal travel to client sites for onboardings and/or performance management (as needed)
• Perform other duties as assigned

Qualifications

• Minimum of 5+ years of demonstrated knowledge and expertise of physician revenue cycle, physician professional coding, and physician professional billing and practice workflows
• Minimum of 3+ years experience managing a global revenue cycle team of direct reports (billers and coders) and vendor partners
• Minimum 3 years experience in a supervisory role
• Certified Professional Coder (CPC) required with a minimum of 10+ years of experience in Evaluation & Management Coding and various specialties
• Certified Professional Biller (CPB) preferred
• Coding Auditing experience preferred
• Compliance experience a plus
• Ability to work effectively with clinicians and staff to implement change
• Strong communication, analytical, reporting and project management skills
• Strong denial management experience
• Strong knowledge of E/M (Evaluation & Management) coding and Value Based Care Coding
• Experience with athenahealth PMS/EHR a plus
• Experience with multi-specialty service lines and coding/billing preferred
• Must comply with HIPAA rules and regulations

The salary range for this role is $110,00.00-$120,000.00 in base pay and exclusive of any bonuses or benefits. This role is also eligible for an annual bonus targeted at 15%. 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.