Virta is the first company with a clinically-proven treatment to safely and sustainably reverse type-2 diabetes without the use of medications or surgery. Our innovations in nutritional biochemistry, data science and digital tools combined with our clinical expertise are shifting the diabetes treatment paradigm from management to reversal. Our mission: reverse type 2 diabetes in 100 million people by 2025.

Virta is rapidly growing its Direct-to-Patient business and further developing its revenue cycle management capabilities. Part of the rapid growth is an increase in volume of claims-based fee-for-service (FFS) billing with major health plans. The Revenue Cycle Specialist will play a vital role in mapping out our FFS billing strategy and will support daily billing and collection efforts as well as possible coding optimization. The Revenue Cycle Specialist will be responsible for identifying and coordinating claims denial trends, and performing necessary collection efforts to overturn denials.

Responsibilities

• • Revenue Cycle Accounts Management 
  • Charge entry into RCM platform (athenaCollector) 
  • Outstanding AR follow-up and status inquiry with payers
  • Research technical claims denials related to payer policies
  • Filing corrected claims and managing claim rejections
  • Identifying and providing reporting on denial trends and underpayments
  • Understanding eligibility and benefit information related to CPT, HCPCS and ICD10
  • Manage payer projects related to issue resolution
  • Maintain and update billing guide for accurate payer-specific reimbursement requirements
  • Respond to billing inquiries while providing world class customer service
  • Review account credit balance and recommend credit refund
  • Review and recommend write off/adjustments for uncollectible accounts to manager

  
  

  • Process Improvement and Development
  • Initial claims testing and tracking for new billing setup with payers
  • Ability to coordinate process issues and improvements with cross functional teams that affect billing processes
  • Be a subject matter expert (SME) for full Direct-to-Patient revenue cycle process 
  • Identify gaps in revenue cycle process and collaborate with manager on process improvements
  • Collaborate with manager on continuous documentation of revenue cycle management processes

90 Day Plan

Within your first 90 days at Virta, we expect you will do the following:

• Master navigation and usage of RCM platform 
• Perform a complete claims review of current claims billing accounts, identify payer issues and recommend resolution
• Master specific client-payer billing requirements 
• Learn and become a subject matter expert in the process of onboarding a new client and billing setup
• Meet with cross functional teams that contribute to billing process by attending cross functional meetings
• Collaborate with manager on RCM platform process documentation

Must-Haves

• 5+ years of experience in revenue cycle management in various healthcare settings
• Experience and knowledge in commercial payer policies, regulation and requirements 
• Certified professional coder (AAPC) with experience in professional billing requirements
• Knowledge in CPT, HCPCS, ICD-10 coding 
• Proficient in understanding and reconciling EOB’s
• Experience in Athena preferred, but not required 
• Experience with telemedicine-specific coding preferred, but not required
• Critical thinking and problem solving skills
• Background in project management and coordination
• Excellent computer, technology, and online application skills

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

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.

For this role the compensation range for candidates in Colorado is $25.00 - $35.00/hr; information about Virta’s benefits is on our careers page at: https://www.virtahealth.com/careers. 

Note: Starting pay will be based on a number of factors and commensurate with qualifications & experience. Virta has a location based compensation structure; there may be a different range for candidates in other locations.