Billing Specialist

• Prepare and submit professional claims
• Correct routine claim errors and rejections
• Work assigned billing and follow‑up queues in Epic
• Apply foundational knowledge of CPT, ICD‑10‑CM, modifiers, and payer rules
• Meet productivity, quality, and timeliness standards

Professional Billing Specialist – Follow Up and Denials

• Prepare, review, and submit Medicare Part A & B claims for skilled nursing residents.
• Ensure timely and accurate billing in accordance with CMS and SNF-specific guidelines.
• Verify resident insurance eligibility, including benefits and coverage under Medicare.
• Monitor and reconcile claims for proper payment, and identify/resolve any discrepancies.
• Track, appeal, and resolve denied or rejected claims efficiently.
• Collaborate with MDS coordinators to ensure billing aligns with clinical documentation under PDPM.
• Maintain current knowledge of Medicare regulations, SNF billing codes, and HIPAA compliance.
• Communicate with Medicare MACs, community staff, and insurance providers as needed.
• Generate aging reports and assist in collection efforts when required.
• Support audits and provide documentation for compliance reviews.

• Join us as a Patient Billing Specialist, where you’ll support patients with payment processing, billing education, insurance verification, and claims-related inquiries.
• This role delivers empathetic, accurate, and compliant service while navigating healthcare billing systems and policies.
• Agents perform all payment processing and payment plan functions in addition to advanced billing, insurance, and claims support.
• Accurately process patient payments via phone in accordance with Privia financial responsibility policies.
• Create, update, and maintain payment plans following established guidelines.
• Ensure transaction accuracy, proper documentation, and data integrity.
• Interpret and clearly explain claim notes, balances, and billing outcomes to patients.
• Verify, audit, and update insurance information for completeness and accuracy.
• Add or update insurance data within the EMR and resubmit pending or corrected claims.
• Educate patients on billing concepts including coordination of benefits, deductibles, coinsurance, copays, timely filing, and claim denials.
• Identify discrepancies and coordinate with internal teams to resolve billing-related issues.
• Research account history to determine the root cause of billing or payment concerns.
• Recommend appropriate resolutions and next steps in alignment with Privia policies.
• Maintain professionalism and empathy during complex or sensitive financial discussions.
• Utilize Privia-approved billing systems, EMR platforms, tools, and knowledge resources.
• Navigate multiple systems simultaneously while assisting patients.
• Adhere to all documentation, privacy, and security requirements.
• Maintain schedule adherence and consistent availability during assigned hours.
• Complete all required Privia and client-mandated training.
• Participate in ongoing uptraining and cross-training initiatives.
• Uphold HIPAA requirements, confidentiality standards, and Privia security protocols.
• Demonstrate professionalism, accountability, and patient-centered service in all interactions.

Patient Billing Representative

• Act as a primary financial point of contact for customers, managing billing inquiries, payment discussions, and dispute resolution with professionalism and commercial awareness
• Review, structure, and process complex customer contracts and purchase orders in partnership with Sales, Legal, and Revenue Operations
• Ensure accurate order setup and billing alignment with contractual terms, pricing structures, and subscription models
• Own the end-to-end billing process across business units, ensuring invoices are accurate, timely, and compliant with contract terms
• Manage the Group’s debtors ledger, maintaining accuracy, integrity, and timely follow-up on outstanding balances
• Lead collections efforts, conducting firm yet relationship-focused conversations with customers to drive timely payments
• Handle complex billing disputes and escalations, balancing customer satisfaction with company policy and revenue protection
• Manage customer onboarding processes, oversee portal administration, and coordinate purchase order management to ensure smooth and efficient operations
• Perform detailed account reconciliations, identifying root causes of discrepancies and implementing preventative solutions
• Monitor and analyze debtor balances on a regular basis, identifying trends, risks, and opportunities for improvement
• Prepare and present aged receivables reporting with actionable insights and recommendations
• Partner closely with Sales, GTM Leadership, Legal, and Finance to streamline contract-to-cash workflows
• Act as a subject matter expert on billing and invoicing processes, clearly communicating financial concepts to non-finance stakeholders
• Identify and drive process improvements to enhance billing accuracy, customer experience, and operational efficiency
• Contribute to special projects focused on scaling systems, improving reporting, and optimizing customer financial interactions

Senior Billing Analyst

• Review pre-bills to ensure compliance with client guidelines, including rates and cost exceptions.
• Generate and distribute pre-bills on a monthly basis.
• Participate in monthly meetings with partner to review unbilled and AR inventory.
• Process narrative edits and time and cost adjustments.
• Aggregate, compile and summarize receipts and documentation for third party expenses to be billed to client.
• Preparation of client statements as requested, including timekeeper summaries / cover sheets illustrating total fees and total expenses incurred and/or billed.
• Upload LEDES invoices via e-billing hub and various e-billing websites, as necessary.
• Address internal and external inquiries in connection with billed and unbilled totals, payment status and matter history.
• Prioritize tasks to ensure invoices are distributed, mailed or e-billed timely.
• Maintain billing files/e-files and retrieve back-up for the department, timekeepers, audits, and other inquiries.
• Participate in collections activities as needed, and identify and escalate deductions and/or collections issues.
• Maintain telephone, email and personal contact with clients, attorneys, and staff.
• Works closely with attorneys, clients, secretaries, and collections staff to assist with client billing collections.
• Works as requested on special projects, analysis and implementation of special billing requests.
• Generates reports as needed by billing Partners/secretaries/client.
• Observe confidentiality in all Firm and client matters.
• Other duties as they arise.

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