RCM Front End 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 a Front End Lead Specialist, you play a critical role in the success of Virta’s revenue cycle operations. You’ll own complex client billing configurations and ensure every billing process is executed with accuracy, consistency, and care. You’ll also oversee and manage Data and Charge Entry contractors, ensuring all billing data, charge reconciliations, and claim submissions are accurate, complete, and aligned with operational timelines. This role is ideal for a seasoned individual contributor who thrives on problem-solving, collaboration, and continuous improvement. You’ll act as a bridge between implementation, operations, and analytics—bringing structure, clarity, and leadership to the front-end revenue cycle. RESPONSIBILITIES Claims Billing Implementations - Lead and oversee the configuration and setup of new client billing accounts, ensuring full operational readiness and accuracy. - Partner with cross-functional teams (Engineering, Credentialing, Eligibility, Finance) to ensure seamless onboarding and payment setup. - Maintain and evolve documentation for onboarding, configuration, and customer contract updates. - Own and maintain the Price Book, ensuring accuracy across all billing and payer setups. - Lead and complete billing testing to validate configurations and prevent downstream issues. - Interpret and apply eligibility, benefit, and coding details (CPT, HCPCS, ICD-10) to ensure compliance and precision in all setups. - Serve as a key contributor in scaling implementation processes—developing documentation, recommending automation, and improving workflows. Charge Entry Team Lead - Serve as a subject matter expert (SME) for front-end RCM processes and system integrations. - Oversee and manage Data and Charge Entry contractors and FTEs supporting team direction and deliverables - Lead small-to-medium process improvement projects focused on automation, accuracy, and scalability. - Drive enhancements across platforms such as Athena, Zuora, and Salesforce, ensuring downstream billing logic remains accurate. - Mentor and support junior team members and contractors, sharing institutional knowledge, reviewing work, and modeling effective communication and problem-solving. - Communicate proactively, constructively resolving differences and aligning stakeholders through documentation, clear updates, and collaborative planning. 90 DAY PLAN Within your first 90 days at Virta, you will: - Master navigation and daily use of core RCM platforms (Athena, Zuora, Spark, Salesforce, JIRA). - Gain deep expertise in billing requirements for Virta’s key client and payer accounts. - Begin leading and providing directional prioritization to the Charge Entry team. - Lead or co-lead process improvement efforts focused on data integrity and reporting structure development. - Collaborate with cross-functional partners to resolve system inefficiencies and ensure end-to-end process alignment. - Build strong relationships with Data and Charge Entry contractors, establishing alignment on workflows, expectations, and deliverable quality. - Document and share best practices to strengthen the team’s overall knowledge base. MUST-HAVES - 3–5+ years of experience in healthcare revenue cycle management, including direct billing and payer implementations. - Proven success managing complex accounts, handling escalations, and resolving exceptions with professionalism and clarity. - Experience overseeing and managing Data and Charge Entry contractors, ensuring accuracy across charge entry, reconciliation, billing data, and related operational workflows. - Advanced understanding of commercial and government payer policies, reimbursement methodologies, contract requirements, and CPT, HCPCS, and ICD-10 coding. - Experience leading small projects or process improvement initiatives, with the ability to analyze data, identify trends, and build reporting frameworks that drive operational decision-making. Familiarity with product development or systems optimization is preferred. - Strong technical proficiency with Athena, Zuora, Salesforce, and JIRA (or similar RCM systems), along with excellent communication skills and a collaborative, solutions-focused mindset. - Demonstrates a proactive use of AI tools to improve individual output and efficiency. 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