Medical Claims Billing Specialist

Privia Health is a technology-driven national physician enablement company that works with medical groups, health plans, and health systems to optimize physician practices, improve patient experiences, and support high-value care delivery in both in-person and virtual settings.

This is a hybrid full-time role based in Houston, TX. The position requires in-office work on Tuesdays and Thursdays at 1200 Binz St Suite 1490, Houston, TX 77004, with Monday, Wednesday, and Friday typically worked from home, subject to change for internal meetings, trainings, and conferences.

Under the direction of the Manager of Revenue Cycle Management, the Medical Claims Specialist is responsible for accurate and timely processing of designated claims, reviewing daily correspondence from physician practices, answering incoming Salesforce cases, and resolving issues escalated to the revenue cycle management team. A key part of the role is managing and resolving Salesforce cases and coordinating issue resolution across the team.

Primary responsibilities include denial management, claim adjustments, resubmissions, appeals, collaboration with internal teams and care center staff, and supporting reimbursement efforts aligned with payer contract agreements. The role also works directly with practice consultants and physicians to help ensure optimal revenue cycle functionality and to support departmental KPI goals.