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 Sr. Enrollment Systems Manager is responsible for the setup, maintenance, and
optimization of enrollment tables within the athenahealth system, ensuring seamless
electronic transactions for Electronic Remittance Advice (ERA) and Electronic Funds Transfer
(EFT) enrollments. This role collaborates closely with internal credentialing, enrollment and
revenue cycle teams to ensure accuracy, compliance, and efficiency in enrollment tasks and
workflows within athena.
Primary Job Duties
● Configure and maintain payer enrollment tables within the athenahealth system.
● Act as a liaison between athena, credentialing, enrollment and RCM teams to resolve
enrollment-related issues
● Ensure proper alignment of payer IDs, provider group enrollments, and claim
submission details.
● Oversee payer ERA and EFT enrollment submissions, ensuring timely processing and
resolution of issues.
● Monitor released claim activity and troubleshoot discrepancies.
● Work with finance and accounting teams to ensure proper banking setup and
reconciliation of EFT transactions.
● Maintain compliance with HIPAA and payer regulations related to electronic
transactions.
● Monitor payer bulletins and updates to stay ahead of changes impacting electronic
transactions.
● Collaborate with revenue cycle, credentialing and enrollment teams to enhance
system functionality and automation.
● Develop and refine standard operating procedures (SOPs) for enrollment processes
related to athena setup and workflows.
● Generate and analyze athena enrollment reports to track processing times and
outstanding tasks.
● Identify and implement opportunities for automation and workflow enhancements.
Qualifications
● Bachelor’s degree in healthcare administration, business, IT, or a related field (or
equivalent experience).
● 5+ years of experience in provider enrollment, revenue cycle management, or
healthcare IT.
● Strong knowledge of athenahealth system setup, payer enrollment, ERA, and EFT
workflows.
● Knowledge of EDI transactions, HIPAA 835/837 standards, and banking processes
related to EFTs.
● Experience working with Medicare, Medicaid, and commercial payers.
● Excellent problem-solving, analytical, and communication skills.
● Proficiency in Microsoft Excel, EHR/PM systems, and enrollment portals.
● Ability to manage multiple priorities and work collaboratively across departments.
● Advanced Microsoft Excel skills (ex. pivot tables, VLOOKUP, sort/filtering and formulas).
The salary range for this role is $100,000 to $110,000 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% based on performance in the role. 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.
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