Privia+ Coding & Provider Relations Specialist

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 Privia+ Coding & Provider Relations Specialist. will be accountable for providing ongoing support of the Privia+ services for enrolled Privia providers and their staff. The Privia+ Success Associate will serve as an integral member of the Privia+ program team, responsible for pulling provider data, monitoring key performance indicators, and proactively escalating performance concerns to the Privia+ team. This person will collaborate with the Privia+ Success Manager and Privia+ Program Managers to drive overall program success and retention, while also assisting with day-to-day provider and office support. The ideal candidate will draw on existing expertise in using data to drive change and have a passion for improving physician workflows and experience.

• Monitor program key performance indicators on a weekly basis
• Track and manage resolutions of outstanding provider and staff questions
• Accurately escalate and triage provider coding questions
• Collaborate with Privia+ and Privia teams, as well as internal and external customers on performance issues and KPI’s
• Assist providers in understanding documentation requirements to support appropriate code selection
• Provide accurate and timely coding guidance to providers and their staff on complex coding scenarios, including CPT, ICD-10, and HCPCS codes
• Research and interpret official coding guidelines (e.g., AMA, CMS) to ensure compliance and optimal reimbursement
• Contributes to the achievement of established department goals and objectives and adheres to department policies, procedures, and quality standards.
• Other duties as assigned

Qualifications

• High School diploma, Medical Office training certificate or relevant experience preferred
• Certified Professional Coder (CPC) or equivalent certification required
• 2+ years of relevant coding medical professional services experience including knowledge of ambulatory coding, including evaluation and management (E/M) services, surgical procedures, and diagnostic coding
• Minimum 2+ years account management, customer or client facing experience
• Excel experience required; CRM (Salesforce) and data management experience preferred
• athenaOne experience preferred
• Experience working in a healthcare or physician practice setting preferred
• Must comply with HIPAA rules and regulations
• Ability to work in a fast-paced environment with all levels of management
• Strategic and tactical; able to help scale operations for growth
• Effective in engaging in direct and sensitive dialogues with physicians and their office leadership
• Clear and concise oral and written communications
• Knack for prioritizing efficiently and mutli-tasking
• Competent in maintaining confidential information
• Thrives in dynamic or evolving environments

The salary range for this role is $63,000.00 - $70,000.00 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.

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.

Originally posted on Himalayas