Title: Medical Claims Billing Specialist (Georgia) Location: Remote United States Job Description: Under the direction of the Manager of Revenue Cycle Management, the Accounts Receivable (AR) Manager is responsible for ensuring the accurate and timely processing of all assigned claims. This role includes promptly addressing daily correspondence from physician practices, reviewing and appealing insurance claim denials and following up on aged claims. The AR Manager will take the steps necessary to resolve all claim issues or questions that escalate to the RCM team to include Salesforce case management. Primary Job Duties: - Management of the accounts receivable (AR) including analysis of the aged AR, looking for root - cause issues; suggesting billed rules/edits when appropriate to stop errors from occurring - Denial management - investigate denial sources, resolve and appeal denials which may include - contacting payer representatives - Make independent decisions regarding claim adjustments, resubmission, appeals, and other - claim resolution techniques - Collaborate with internal teams (Performance, Operations, Sales) as well as, care center staff - when appropriate - Support large care center go lives when applicable, which may include overnight travel - Work closely with our Revenue Optimization team to support efforts to ensure reimbursement is in - line with payer contract agreements. Perform denial analysis utilizing the Trizetto platform. - Work directly with practice consultants or physicians to ensure optimal revenue cycle functionality - Drive toward achievement of department's daily and monthly Key Performance Indicators (KPIs) - Other duties as assigned - High School Graduate - 3+ years experience in a medical billing office or equivalent claims experience - Must understand the drivers of revenue cycle optimal performance and be able to investigate and resolve complex claims - Advanced Microsoft Excel skills (ex: pivot tables, VLOOKUP, sort/filtering, formulas) preferred - Experience with athenaHeath and/or athenaOne preferred - Experience with Georgia payers and portals preferred - Must comply with HIPAA rules and regulations The hourly range for this role is $24/hr to $26.45/hr in hourly base pay and exclusive of any bonuses 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 10%. The base pay offered will be determined based on relevant factors such as experience, education, and geographic location. 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. We understand that healthcare is local and we are better 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.

Care Center Customer Service & Billing Specialist Location: Remote, USA, United States Employees can work remotely Full-time Department: Customer/Member Experience 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 Must be available to work any 8 hour shift between the hours of 8am-6pm EST, remotely. The Sr. Care Center Support Billing Specialist supports our growing physician network. This person will assist customers with all questions around billing/claims resolution,via current email technology platforms and incoming calls. The role operates within a customer service oriented high-volume call center environment. Primary Job Duties - Responding to high volume inquiries via email/phone - Assist with triaging case volumes - Providing resolution guidance/support to care center staff on complex claims/billing inquiries; claim holds, overrides, take backs, corrected claim workflows, coding assistance - Critically analyze a situation and escalate issues to the appropriate internal team; meticulously following up to ensure that the customer is served in a timely fashion - Identify issues that occur on a repeated basis and provide feedback to management - Act as a subject matter expert for all current and updated resources, ensuring to communicate updates to fellow team members and ensuring understanding - Provide support in team chat with questions from team members - Remain flexible to take on other duties as assigned Qualifications - High School Diploma preferred, advance certification a plus - Familiar with healthcare billing and claim resolution preferred - Experience with AthenaNet, Salesforce a plus - 2+ years of full time experience in a call center customer service environment - Familiarity using software such as Salesforce, Word, Excel, Web Browsers and cloud-based web applications - Must provide accessibility to private, quiet work space with high-speed internet to effectively work remotely The hourly range for this role is $21/hr to $23/hr in hourly base pay and exclusive of any bonuses 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 10%. 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. We understand that healthcare is local and we are better 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.

Title: Head Start Grants Management Specialist- REMOTE Location: United States Full time Job Description: ICF seeks an experienced Grants Management Specialist to provide ongoing, prompt and accurate fiscal assistance to Head Start (HS) and Early Head Start (EHS) grantees and will support Federal staff with high quality grants management services. This includes preparing and tracking grants through review and funding processes, monitoring receipt and accuracy of grant documents, monitoring, evaluating and resolving grant issues, and preparing grant closeouts. The Grants Specialist will be a critical thinker with outstanding attention to details and an eye towards process improvement. Key Responsibilities: - Review and take action on applications so that they may be funded 30 days prior to a grantee's refunding date. Prepare continuation Financial Assistance Awards (FAAs) with cover letters for mailing out 30 days prior to a grantee's refunding date. - Prepare and track grants through review and funding process. Deliverables include completed grant review checklist, timely contact with grantees to resolve issues, negotiation sheets and FAAs prepared in Grants Solutions software, briefing meetings with program staff and with management, leading to the awarding of annual continuation grant awards, program improvement grant awards, cost-of-living grant awards, and one-time funding awards to grantees. - Monitor timeliness, receipt and accuracy of grant applications, financial reporting documents and financial draw downs. - Correspond with grantee staff on a regular basis. - Monitor ongoing fiscal performance of grantees, evaluation of required fiscal reports, wage comparability study; resolution of audit findings and recommendations; and resolution of community/individual complaints. - Prepare grant closeouts. Deliverables include completed closeout checklist, assurance that reports and audits have been reviewed for completeness and correctness, a closeout letter that is sent to the grantee, and a closeout award processed in the Grants Solutions software system. Basic Qualifications: - Bachelor's Degree from an accredited university or college, with a preference for a degree in Accounting, Business Management, or a related field. - 2+ years of progressive professional experience - 2+ years' experience related to federal discretionary grants management non-profit or for-profit financial management, and regulatory compliance monitoring and oversight. - 1+ years' experience aggregating, analyzing, charting, graphing and reporting on and presenting data gathered from multiple sources. - 1+ years knowledge and experience with the administration of discretionary grants is required; with a preference for Head Start/Early Head Start Programs. - 1+ years' experience with Microsoft Outlook, Word, Excel and PowerPoint. - Must have valid driver's license and successfully pass a Motor Vehicle Records (MVR) check. Preferred Skills/Experience: - Experience with Grant Solutions. - Background and training in accounting and/or financial management, including audit resolution activities. Professional Skills: - Excellent verbal and written communication skills required. - Strong analytical, problem-solving and decision-making capabilities. - Strong team player, with the ability to collaborate and work closely with Regional Office staff and other partners. - Ability to work with all levels of internal staff, as well as outside clients. - Superior attention to detail and the ability to meet stringent deadlines. - Ability to be flexible, multi-task, prioritize, and manage multiple activities simultaneously in a fast-paced, changing environment. - Exceptional interpersonal skills including courtesy, professionalism, and a cooperative attitude. - Ability to build productive business relationships. - Excellent time management and communication skills. - Ability to exercise good judgment, discretion, tact, and diplomacy. Working at ICF ICF is a global advisory and technology services provider, but we're not your typical consultants. We combine unmatched expertise with cutting-edge technology to help clients solve their most complex challenges, navigate change, and shape the future. We can only solve the world's toughest challenges by building a workplace that allows everyone to thrive. We are an equal opportunity employer. Together, our employees are empowered to share their expertise and collaborate with others to achieve personal and professional goals. We will consider for employment qualified applicants with arrest and conviction records. Candidate AI Usage Policy At ICF, we are committed to ensuring a fair interview process for all candidates based on their own skills and knowledge. As part of this commitment, the use of artificial intelligence (AI) tools to generate or assist with responses during interviews (whether in-person or virtual) is not permitted. Pay Range - There are multiple factors that are considered in determining final pay for a position, including, but not limited to, relevant work experience, skills, certifications and competencies that align to the specified role, geographic location, education and certifications as well as contract provisions regarding labor categories that are specific to the position. The pay range for this position based on full-time employment is: $55,665.00 - $94,631.00 Nationwide Remote Office (US99)

• Review daily point-of-service (POS) pharmacy claims, resolve actionable items, track, and provide reporting • Investigate and resolve pharmacy claim rejections, reversals, and payment discrepancies in real time • Collaborate with external pharmacy and claims teams to ensure accurate claim adjudication and payment • Submit and track claim overrides when appropriate and compliant with plan and CMS guidelines • Facilitate the prior authorization process by working with prescribers, pharmacies, and internal clinical staff • Monitor PA status and proactively communicate determinations and next steps to pharmacies and providers • Serve as primary billing and claims contact for contracted network and long-term care pharmacies • Communicate professionally with pharmacy billing teams, prescribers, and facility staff to resolve claims issues • Educate pharmacies and provider offices on billing requirements, formulary limitations, and plan processes • Support transitions of care by ensuring medication access and clean claim processing for new or discharged members • Maintain compliance with CMS Medicare Part D regulations, HIPAA, and plan policies • Accurately document all claim interventions, communications, and resolutions in the plan’s system • Assist with internal audits, reporting, and quality improvement initiatives related to claims and billing • Identify trends in claim rejections or PA delays and escalate systemic issues to leadership • Monitor daily billing and claims work queues and meet productivity and turnaround time expectations • Participate in cross-functional meetings with pharmacy operations, clinical, and provider relations teams • Support process improvement initiatives to enhance claims efficiency and member access to medications • Serve as a liaison with Enrollment Department to assure appropriate member eligibility processing • Recognize formulary requirements: prior authorization (PA), Step Therapy (ST), Quantity Limit (QL) and understand NCPDP reject codes • Coordinate clinical reporting • Follow-up and solve open items in a timely manner • May be assigned to work on special projects and business initiatives