Jobs at Privia Health

Process and resolve insurance-related credits and refunds for physician practices using athenaNet and Salesforce. Review correspondence, research overpaid/denied claims, prepare and mail refund checks (35+ daily), handle returned checks, sort RCM mail, and follow payer-specific workflows while maintaining HIPAA compliance.

Manage payer enrollment for New Jersey independent providers and care centers: enroll new groups/providers with commercial and federal payers, maintain payer data in CredentialStream, investigate claims/enrollment issues, resolve inbound claims in AthenaOne EMR, handle Salesforce case resolution, and coordinate onboarding with internal teams.

Lead implementation and training for physician practices: project-manage EMR and practice-management launches, train clinicians and staff, coordinate with Finance/IT/Billing/Credentialing, manage lab launches and post-live adoption, maintain project plans, and travel extensively to support market rollouts.

Manage accounts receivable and denial lifecycle for physician practices: analyze aged AR, investigate and appeal denials, make claim adjustments/resubmissions, collaborate with internal teams and practices, support go-lives (may include overnight travel), use Trizetto and Salesforce for case/denial management, and drive daily/monthly RCM KPIs.

Lead and train RCM staff, manage claims submission and aged AR resolution, analyze denials, implement process improvements, handle escalations, manage performance metrics, and support hiring, coaching, and cross‑functional projects.

Provide subject-matter expertise in CPT/ICD-10/HCPCS coding by designing and delivering specialty-specific training, analyzing coding performance, scheduling and leading remote and group sessions, developing educational materials, resolving coding compliance inquiries within SLAs, and driving documentation and coding improvement initiatives.

Lead and manage a Salesforce engineering delivery team to design, build, test, and deploy scalable, secure Salesforce solutions. Drive Agile/DevOps practices, release governance, platform architecture evolution, AI readiness, integrations (MuleSoft/REST/Data Cloud), HIPAA/PHI compliance, and cross-functional alignment to the enterprise roadmap while maximizing sprint efficiency and platform stability.

The Operations Consultant II manages physician practices, driving performance improvements, overseeing financial metrics, and mentoring practice administrators. Responsibilities include strategic planning, enhancing workflow, and ensuring compliance with regulations.

The Sales Development Representative generates leads for Growth Directors, conducts outreach to prospects, and supports sales functions, aiming to increase unique qualified encounters with potential clients.

The Coding Compliance Audit & Education Specialist audits medical records for compliance with coding regulations, conducts education for providers, and ensures adherence to federal and state coding guidelines.

The Coding Compliance Audit & Education Specialist audits medical records for compliance, educates providers on coding guidelines, and prepares audit reports. They conduct trainings, communicate findings, and provide consultation to ensure compliance with federal regulations.