RCM Collections Lead Specialist

Job description

Virta Health is on a mission to reverse metabolic disease in one billion people. Current treatment approaches aren’t working—over half of US adults have either type 2 diabetes or prediabetes, and obesity rates are at an all-time high. Virta is changing this by helping people reverse their metabolic condition through innovations in technology, personalized nutrition, and virtual care delivery reinvented from the ground up. We have raised over $350 million from top-tier investors, and partner with the largest health plans, employers, and government organizations to help their employees and members restore their health and take back their lives. Join us on our mission to reverse metabolic disease in one billion people. As Collections Lead Specialist, you'll lead a team of Collections Specialists responsible for AR follow-up and denial resolution across Virta's Tier 3 account portfolio. This is a "player-coach" role where throughput, consistency, and coaching quality are the primary levers for performance. You'll split your time between developing your direct reports and working accounts yourself, serving as the escalation resource for your team on payer issues that need a more experienced hand. This role reports to the RCM Back End Manager. RESPONSIBILITIES - Team Development: Lead and develop a team of Collections Specialists, setting daily priorities and holding the team accountable to follow-up cadences and high documentation standards. - Portfolio Ownership: Act as a "working lead" by directly managing a portion of the Tier 3 AR portfolio, including payer follow-up, denial resolution, and escalation calls. - Escalation Support: Serve as the first point of contact for your team on complex denials, payer disputes, and accounts requiring advanced review or documentation. - Performance Monitoring: Track team-level AR aging and denial trends, reporting on performance against KPIs and flagging systemic issues to leadership with data-supported recommendations. - Operational Consistency: Ensure the team consistently utilizes productivity scorecards, standardized follow-up templates, and auditable documentation practices. 90 DAY PLAN Within your first 90 days at Virta, we expect you will do the following: - 30 Days: Get oriented in Virta's RCM platforms and understand the Tier 3 portfolio structure, payer mix, and current aging. Meet your team to understand their current workflows and identify early coaching opportunities. - 60 Days: Establish clear productivity expectations and accountability systems for follow-up cadence and documentation. Begin serving as the escalation point for complex accounts and providing a weekly performance summary to your manager. - 90 Days: Identify high-risk patterns in the AR aging queue and develop a targeted action plan to address them. Lead one team-level improvement initiative, such as a payer-specific workflow refresh or a training session on recurring denial types. MUST-HAVES - Experience: 4+ years in healthcare Revenue Cycle Management with a specialized focus on collections and AR follow-up. - Mentorship: Previous experience leading, mentoring, or training billing specialists or contractors in an RCM environment. - Data Proficiency: Advanced Excel skills (VLOOKUPs, Pivot Tables, data cleaning) to manage complex reconciliation reports and audit large datasets for accuracy. - Specialized Knowledge: Expert-level understanding of CPT, HCPCS, and ICD-10 coding, commercial/government payer timely filing limit policies, and claim adjudication. - Technical Mastery: Proficiency with navigating EHRs (Athena or Candid Health experience a plus), clearinghouse platforms, payer portals and CRM platforms such as Salesforce. - Multi-tasking: Proven ability to remain organized while managing both a team workload and a personal account portfolio simultaneously. VALUES-DRIVEN CULTURE Virta’s company values drive our culture, so you’ll do well if: - You put people first and take care of yourself, your peers, and our patients equally - You have a strong sense of ownership and take initiative while empowering others to do the same - You prioritize positive impact over busy work - You have no ego and understand that everyone has something to bring to the table regardless of experience - You appreciate transparency and promote trust and empowerment through open access of information - You are evidence-based and prioritize data and science over seniority or dogma - You take risks and rapidly iterate Is this role not quite what you're looking for? Join our Talent Community https://jobs.ashbyhq.com/virtahealth/form/talent-community-form and follow us on Linkedin https://www.linkedin.com/company/virta-health to stay connected! Virta has a location based compensation structure. Starting pay will be based on a number of factors and commensurate with qualifications & experience. For this role, the compensation range is $64,500-$83,500/year. Information about Virta’s benefits is on our Careers page at: https://www.virtahealth.com/careers. As part of your duties at Virta, you may come in contact with sensitive patient information that is governed by HIPAA. Throughout your career at Virta, you will be expected to follow Virta's security and privacy procedures to ensure our patients' information remains strictly confidential. Security and privacy training will be provided. As a remote-first company, our team is spread across various locations with office hubs in Denver and San Francisco. Clinical roles: We currently do not hire in the following states: AK, HI, RI Corporate roles: We currently do not hire in the following states: AK, AR, DE, HI, ME, MS, NM, OK, SD, VT, WI. Virta uses Ashby as its applicant tracking system, which incorporates AI-powered tools (provided by OpenAI, AWS, and Google Gemini) in certain aspects of the recruiting process, including application review, candidate screening, and interview note taking; your data is not used to train AI models, and all final hiring decisions are made by Virta Health personnel. For more information, see Ashby's AI Terms at https://www.ashbyhq.com/resources/terms-ai-features #LI-remote