Senior Manager, Billing & Coding

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 Senior Manager Privia+ oversees the BILLER+ and CODER+ offerings under the Privia+ brand and will report to the Director Privia+. This person is accountable for the success of these programs and manages the day-to-day operations for a growing customer base. This includes but is not limited to creating and maintaining SOP (Standard Operating Procedure) documentation ensuring compliance at every step in the process providing direction to a cross-functional team and holding team members and vendor partners accountable to meet SLAs and performance expectations. The ideal candidate has operational and project management skills experience managing a global workforce  and deep subject matter knowledge of physician revenue cycle physician professional coding (Pro-Fee) and physician practice workflows in a multi-specialty physician practice environment.

Primary Job Duties:

Responsible for overall operational and programmatic success of BILLER+ and CODER+ including (Pro-Fee) and physician practice workflows in a multi-specialty physician practice environment.

Primary Job Duties:

• Responsible for overall operational and programmatic success of BILLER+ and CODER+ including vendor partnerships operational performance and client satisfaction

• Manage a global workforce of employed staff and vendor contracted billing and coding teams to ensure delivery 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 operations escalations team alignment and any other relevant operational area

• Serve as the primary escalation point for addressing operational and performance issues with vendors partner organizations and internal staff

• Work closely with Director to identify best practices to maximize accuracy efficiency and effectiveness of coding support services to providers.

• Partner with Implementation to ensure successful customer go-lives for large or complex customer implementations and ensure proper system setup

• 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

• Research and resolve identified issues/questions from clients/internal stakeholders

• Manage salesforce cases and ensure they are being addressed timely by assigned staff

• Minimal travel to client sites for onboardings and performance management (as needed)

• Perform other duties as assigned

Qualifications

• Certified Professional Coder (CPC) required with 5+ years of experience in Evaluation & Management Coding and various specialties

• Certified Professional Biller (CPB) preferred

• Coding Auditing experience preferred

• 5+ years of demonstrated knowledge and expertise of physician revenue cycle physician professional coding and physician professional billing and practice workflows

• 3+ years experience managing a global revenue cycle team of direct reports (billers and coders) and vendor partners

• Ability to work effectively with clinicians and staff to implement change

• Strong 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 preferred

• Experience with multi-speciality service lines preferred

• Must comply with HIPAA rules and regulations

The salary range for this role is $83000 to $90000 in base pay. This role is also eligible for an annual bonus targeted at 15% and restricted stock units based on performance in the role. 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.