Senior Manager, Billing & Coding (CPC required)

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 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, and 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) and physician practice workflows in a multi-specialty physician practice environment.

Primary Job Duties:

Responsible for overall operational and programmatic success of BILLER+ and CODER+, including (Pro-Fee) and physician practice workflows in a multi-specialty physician practice environment.

Primary Job Duties:

• Responsible for overall operational and programmatic success of BILLER+ and CODER+, including vendor partnerships, operational performance, and client satisfaction
• 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.
• Develop, review, and approve all Standard Operating Procedures (SOPs) regarding operations, escalations, team alignment, and any other relevant operational area
• Serve as the primary escalation point for addressing 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
• Provide updates and reporting on key performance metrics to leadership 
• Regularly communicate program updates, new features and other important information to customers and internal stakeholders
• Solicit feedback from customers on opportunities to improve or enhance programs
• 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
• Manage salesforce cases and ensure they are being addressed timely by assigned staff
• Minimal travel to client sites for onboardings and performance management (as needed) 
• Perform other duties as assigned

Qualifications

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

The salary range for this role is $83,000 to $90,000 in base pay. This role is also eligible for an annual bonus targeted at 15% and restricted stock units based on performance in the role. The base pay offered will be determined based on relevant factors such as exp