Teams 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.