RCM - Front End Specialist

Virta Health

76d

About The Position

As a Front End Specialist, you are at the starting point of our revenue cycle, ensuring every new client begins their journey with Virta on a solid financial footing. You’ll focus on the accurate and timely setup of client accounts for both implementations and direct billing. This role is perfect for a detail-oriented, proactive individual who thrives in a collaborative environment and takes pride in delivering consistent, high-quality work. You’ll play a key role in maintaining operational accuracy, supporting process improvements, and partnering across teams to create a seamless customer onboarding experience.

Requirements

• 1–2 years of experience in a healthcare revenue cycle management role.
• Experience and knowledge of commercial and government payer policies, regulations, and requirements.
• Knowledge of CPT, HCPCS, and ICD-10 coding.
• A background in process improvement and familiarity with product development concepts.
• Strong critical thinking and problem-solving skills, with the ability to resolve issues within defined policies and frameworks.
• Excellent computer, technology, and online application skills.

Responsibilities

• Coordinate and support the setup of new clients (payers and employers), ensuring each onboarding process is completed accurately and on time.
• Assist in configuring client accounts for billing and confirming payments are directed to the correct banking accounts.
• Maintain clear and organized documentation for all onboarding activities and account changes.
• Help maintain the Price Book, ensuring all pricing is current and correctly reflected in the billing platform.
• Support the billing testing process by tracking test claims and verifying payer setup to ensure accuracy, completeness, and minimize denials or payment delays.
• Apply policies, procedures, and professional guidance to resolve routine issues effectively.
• Demonstrate a learning mindset — proactively seeking clarification, validating assumptions before starting work, and ensuring tasks are executed to the highest standard.
• Understand and apply eligibility and benefit information related to CPT, HCPCS, and ICD-10 codes.
• Collaborate with and support contractors or vendor partners assisting in data entry, billing prep, or testing tasks—helping ensure alignment on timelines, accuracy, and process consistency.
• Ensure Billing Guides and Pricing Tickets are complete, accurate, and fully up to date.
• Validate payer setup requirements, including CPT/HCPCS codes, units, modifiers, and POS settings.
• Maintain centralized documentation for each customer, including payer configurations, contract details, go-live checklists, and direct invoice formats.
• Document manual workflows for unusual billing scenarios to support future scaling and automation.
• Submit all Price Books at least 7–14 days prior to launch to prevent retroactive updates and inaccuracies.
• Support the implementation lifecycle across cross-functional teams (Product, RCM, Legal, Operations).
• Own the direct invoicing process, ensuring invoices are generated and delivered accurately and on time.
• Maintain a tracker (billing guide) for all direct invoices, including any formatting or manual intervention needed.
• Keep all direct invoice accounts under 90 days; escalate to Customer Success (CS) and team lead if approaching or exceeding 90 days.
• Own Direct Minimum Billings and Platform Fee Billing and Collections, ensuring accuracy, completeness, and timely processing.
• Generate and deliver invoices for direct-billed clients accurately and on schedule.
• Ensure all applicable contract fees (e.g., minimum billings, platform fees) are billed and collected promptly.
• Respond to internal and external billing inquiries, communicating clearly and frequently to keep stakeholders informed of progress and resolution.
• Manage ad-hoc reporting requests and deliver reliable, data-driven outputs that support business needs.
• Uphold a customer-first mindset, providing world-class service while maintaining accuracy and professionalism in every interaction.
• Support billing reconciliation tasks with oversight from senior team members, ensuring that all invoices and adjustments are properly logged and verified.
• Assist in coordinating with contractors handling supplemental billing or reconciliation work to ensure quality and consistency of outputs.
• Serve as a knowledgeable and reliable contributor to front-end RCM processes, sharing institutional knowledge and supporting new team members as needed.
• Identify blockers or inefficiencies and collaborate with peers and management to improve processes.
• Contribute to the continuous documentation and refinement of RCM workflows, ensuring updates are accurate and accessible.
• Work effectively across functions to coordinate and resolve issues that impact billing.
• Balance independence and collaboration, delivering strong individual results while contributing to team goals and maintaining open communication with peers and managers.

What This Job Offers

• Number of Employees: 501-1,000 employees