Jobs at Privia Health

Manage payer enrollment for New Jersey independent providers and care centers, maintain payer data in CredentialStream, investigate enrollment/claims issues, resolve AthenaOne claims inquiries, coordinate onboarding with internal teams, manage Salesforce cases, and act as liaison between enrollment and stakeholders while ensuring HIPAA compliance.

Manage and train revenue cycle teams to meet AR, quality, and production KPIs. Oversee claims submission, denials analysis, escalations, policy updates, payer projects, and stakeholder communications. Support go-lives, resolve complex claims and Salesforce cases, and assist with staffing and performance management.

Manage accounts receivable and denial management for physician practices using athena platforms and Trizetto. Investigate, appeal, and resolve claim denials, analyze aged AR, collaborate with internal teams and practices, support go-lives (possible overnight travel), use Salesforce case management, and meet department KPIs while complying with HIPAA.

Serve as a strategic HR business partner across multiple units, advising on employee relations, performance management, succession planning, organizational design, change management, compliance, compensation strategy, training rollout, and leadership coaching. Lead cross-functional HR projects and talent reviews to strengthen organizational effectiveness and culture.

Develop and maintain Rails/React applications and cloud-native data architectures. Build data models, SQL pipelines (MySQL, Snowflake), integrate AI-assisted coding tools, create tests, and collaborate in Agile/Scrum with product owners to define data requirements.

Design, build, and maintain end-to-end data pipelines and ETL/ELT for healthcare data using Snowflake, dbt, Python, and SQL. Ensure data quality, monitor production jobs, troubleshoot anomalies, write dbt models and tests, collaborate with Analytics/Operations/Clinical teams, and participate in Agile processes with GitLab and Jira.

Design, build, and maintain automated data quality frameworks and checks using SQL and Python in Snowflake. Apply AI/GenAI for rule generation, anomaly detection, and data observability. Validate BI datasets and pipelines, enforce quality gates in ETL/ELT flows, ensure interoperability with healthcare standards (HL7/X12/FHIR), monitor quality metrics, support governance/audit readiness, and mentor team members.

Own and optimize Care Center website operations on Drupal, manage support queue and vendors, escalate and resolve complex technical issues, track KPIs, support online scheduling rollout and related digital projects (SEO, ORM, DAM).

Audit payer-processed claims and provider/care center data to ensure accurate reimbursement per contracts and fee schedules. Conduct post-implementation Care Center audits, track/report outcomes, identify denial trends, and resolve payment variances. Collaborate with revenue cycle teams, payers, and leadership; manage escalations, support Trizetto/Cognizant fee schedule setup, handle Salesforce cases and AthenaOne tables, and produce reference tools and action plans to optimize cash flow.

Hybrid UX/QA Engineer responsible for validating UI/UX and end-to-end functionality across web and mobile products. Develop and run test plans, automate UI regression (Playwright/Cypress/Selenium), analyze logs and errors (Bugsnag, DevTools), document defects in Jira, and use AI-assisted tools to accelerate test generation and coverage. Collaborate with product and engineering in Agile ceremonies to ensure responsive, accessible, and seamless user journeys.

Deliver risk-adjustment and coding education (HCC, ICD-10-CM, CPT, HCPCS), conduct prospective and retrospective chart audits, analyze coding performance, generate audit reports, lead provider trainings, ensure CMS/AMA compliance, and support documentation improvement initiatives.

Audit medical records for coding compliance (CPT, ICD-10, HCPCS), prepare audit reports, provide provider education and training, interpret federal/state CMS/Medicare regulations, and support coding issue resolution and documentation improvement.

Design, develop, and maintain Salesforce solutions including LWC/LWR UI, legacy Aura support, AI features (Einstein/Agentforce), event-driven integrations, Copado CI/CD, advanced Flows, and data/backup management while providing technical support and stakeholder documentation.

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.