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Virta Health is seeking an RCM Front End Lead Specialist to drive revenue cycle operations and ensure accurate, compliant billing processes. This role combines individual contributor expertise with team leadership responsibilities.
You will own complex client billing configurations and implementations, serving as the subject matter expert for front-end revenue cycle management. Key responsibilities include leading claims billing implementations for new clients, configuring billing accounts in partnership with Engineering, Credentialing, Eligibility, and Finance teams, and maintaining the Price Book across all billing and payer setups. You'll interpret eligibility, benefit, and coding details (CPT, HCPCS, ICD-10) to ensure compliance and precision.
As Charge Entry Team Lead, you will oversee and manage Data and Charge Entry contractors and FTEs, ensuring billing data accuracy, charge reconciliations, and claim submissions align with operational timelines. You'll mentor junior team members, drive process improvement initiatives focused on automation and scalability, and enhance workflows across platforms including Athena, Zuora, and Salesforce.
Your first 90 days will focus on mastering core RCM platforms, gaining deep expertise in Virta's key client accounts, leading the Charge Entry team, and driving data integrity improvements. You'll collaborate cross-functionally to resolve system inefficiencies and document best practices.
Required qualifications: 3–5+ years in healthcare revenue cycle management with direct billing and payer implementation experience. Proven success managing complex accounts, handling escalations, and overseeing Data and Charge Entry contractors. Advanced understanding of commercial and government payer policies, reimbursement methodologies, and medical coding standards. Experience leading process improvement projects with data analysis and reporting capabilities. Strong technical proficiency with Athena, Zuora, Salesforce, and JIRA. Excellent communication and collaborative problem-solving skills. Proactive use of AI tools to enhance efficiency.
