Senior Manager

Role 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
• 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)
• Physician practice workflows in a multi-specialty physician practice environment

Primary Job Duties:

• Responsible for BILLER+ and CODER+, including (Pro-Fee) and physician practice workflows in a multi-specialty physician practice environment
• 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
• Responsible for the delivery of up to date and compliant provider educational materials, including but not limited to, relevant sources and/or payer policies
• Collaborate and develop Standard Operating Procedures (SOPs) regarding coding and billing operations, escalations, team alignment, and vendor/client facing materials
• Serve as the primary escalation point for addressing coding and billing 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
• Partner with customer success to support complex customers as it relates to all coding and billing operations
• Provide updates and reporting on key performance metrics to leadership
• 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
• Occasionally manage salesforce cases and ensure they are being addressed timely by assigned staff
• Perform other duties as assigned

Qualifications

• Certified Professional Coder (CPC) required with a minimum of 5+ years of experience in Evaluation & Management Coding and various specialties
• Certified Professional Biller (CPB) preferred
• Coding Auditing experience preferred
• Minimum of 5+ years of demonstrated knowledge and expertise of physician revenue cycle, physician professional coding, and physician professional billing and practice workflows
• Minimum of 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-specialty service lines and coding/billing preferred
• Must comply with HIPAA rules and regulations

Requirements

• The salary range for this role is $100,000.00 to $108,000.00 in base pay and exclusive of any bonus 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 15%.
• The base pay offered will be determined based on relevant factors such as experience, education, and geographic location.

Benefits

• All your information will be kept confidential according to EEO guidelines.
• Employees who regularly work from home offices are eligible for expense reimbursement to offset this cost.