Jobs at Privia Health

Manages a portfolio of independent physician practices across the Austin and Houston markets, driving financial, operational, clinical, revenue-cycle, and customer-experience performance. Develops growth and improvement plans, optimizes workflows, coaches practice administrators and performance associates, supports value-based care transitions, communicates initiatives, and ensures regulatory compliance. The role requires financial analysis, provider relationship management, project coordination, presentations, and 70% travel throughout the assigned territory.

Manage accounts receivable and medical claim resolution, including aged-AR analysis, denial investigation, appeals, adjustments, resubmissions, and payer follow-up. Collaborate with practices, physicians, care centers, and internal teams to optimize revenue cycle performance and reimbursement. Use Salesforce case management and Trizetto for denial analysis, support care-center launches, maintain HIPAA compliance, and achieve daily and monthly KPIs.

Audits medical records against CPT, HCPCS, and ICD-10-CM codes for regulatory compliance; researches CMS and Medicare guidance; prepares audit reports; educates providers and groups; delivers coding consultation, documentation training, technical support, and issue resolution; tracks education completion and escalates findings when needed.

Manage physician practice accounts receivable and revenue cycle claims, including aged AR analysis, denial investigation, appeals, adjustments, resubmissions, correspondence, and Salesforce case resolution. Serve as an escalation point and subject matter expert, coordinate with practice consultants and physicians, recommend policy updates, and support team KPIs. Ensure claims and AR worklists are accurately reconciled and resolved in compliance with HIPAA and revenue cycle best practices.

Supports employee lifecycle operations, including onboarding, offboarding, employee inquiries, HRIS transactions, compensation documentation, payroll coordination, benefits and leave administration, compliance reporting, training, and engagement initiatives. Maintains audit-ready records, resolves HRIS issues, creates employee-facing materials, and contributes to process improvements and enterprise-wide People Operations projects during a Workday transition.

Manage accounts receivable and medical claims, including aged AR analysis, denial investigation, payer appeals, claim adjustments, resubmissions, and issue resolution. Collaborate with practices, physicians, internal teams, and payers to optimize reimbursement and revenue cycle performance. Use Salesforce case management and Trizetto for denial analysis, support care center implementations, ensure compliance with HIPAA, and meet daily and monthly KPIs.

Manages payer enrollment for independent providers across commercial plans, Medicare, and Medicaid. Reviews provider data, submits applications, tracks enrollment status in CredentialStream, follows up with health plans until providers are participating, and escalates issues. Collaborates with credentialing, revenue cycle management, and internal stakeholders while maintaining HIPAA compliance.

Lead enterprise data architecture on Snowflake, define Medallion Architecture and data modeling standards, guide dbt/Python pipeline frameworks, enforce HIPAA-compliant governance, optimize performance and cost, and mentor engineers while collaborating with analytics, clinical, and product stakeholders.

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.

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.