RCM - Front End Specialist

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.

🔑 Key Responsibilities

Claims Billing Implementations

• 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).
  

Direct Billing

• 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.
  

Process Improvement & Collaboration

• 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.

🚀 90 Day Plan

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

• Master the navigation and daily use of our core RCM platforms (Athena, Zuora, Salesforce, JIRA).
  

• Learn the specific billing requirements for our key client and payer accounts.
  

• Build strong relationships with your assigned customer accounts and internal cross-functional teams.
  

• Understand the end-to-end process for onboarding a new client and setting up billing.
  

• Attend cross-functional meetings to develop visibility into how upstream and downstream teams contribute to billing success.
  

• Collaborate with management to contribute to the evolution and documentation of RCM processes.
  

🎓 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.
  

💙 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.

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.

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