Senior Manager, Back End Revenue Cycle

Responsibilities

• Claim Receipt & Submission Confirmation
• Implement a tracking and escalation process for claims that have not received 277CA acknowledgment within defined payer-specific windows
• Partner with the Front End Revenue Cycle Manager and Engineering to ensure clean claim submission and minimize rejection rates at the clearinghouse level
• Maintain working knowledge of clearinghouse workflows and claim status tracking capabilities
• Own the Athena Health AR aging report — ensuring it accurately reflects payment status and is actively worked on a defined cadence
• Establish AR follow-up workflows by payer and aging bucket, with defined SLAs and escalation paths for each tier
• Drive systematic reduction of the over-180-day AR balance through targeted payer follow-up, appeals, and collections activity
• Coordinate with Finance and the Manager/Director of Operational Effectiveness to ensure AR balances in Athena are accurately reflected in Zuora and NetSuite through a defined reconciliation process
• Identify and escalate AR balances where the insurance collection path has been exhausted and the employer guarantee of payment clause may apply
• Build and manage a structured denial work queue in Athena Health with assigned ownership, defined SLAs, and a clear resubmission process for each denial reason code
• Analyze denial trends by payer, reason code, and service line to identify root causes and implement upstream controls to prevent recurrence
• Prioritize denial resolution based on dollar value and timely filing window expiration — ensuring high-value, near-deadline denials are worked first
• Establish appeals workflows for payer-specific appeal processes, including supporting documentation requirements and submission timelines
• Monitor denial overturn rates by payer and reason code, and use outcomes data to refine appeal strategies
• Partner with the Front End Revenue Cycle Manager to address eligibility-driven denials at the root — denials reflecting coverage terminations that should have been caught upstream
• Manage the collections process for both claims-billed payer populations
• Coordinate with Client Success on employer group collections, including communication protocols and escalation to the employer guarantee of payment process when appropriate
• Monitor and report on cash collection rates by payer against contracted PMPM rates, identifying and investigating variances

Requirements

• Recruit, onboard, and develop back-end RCM staff including AR follow-up specialists, denial management analysts, and collectors
• Establish competency requirements, training programs, and performance expectations for all back-end positions — with particular emphasis on experienced denial management and collections hires
• Conduct regular AR review sessions with staff to ensure accounts are being worked effectively and escalations are appropriate
• Build a culture of accountability, data-driven decision making, and continuous improvement within the back-end team

Qualifications

• 90 Day Plan: Reduce AR over 180 days from 40% to overall denial rate to 60% of appealed claims successfully overturned; timely filing write-off rate to near zero; prevention through upstream controls and active monitoring; DSO to establish baseline and target reduction to

Skills

• Deep expertise in payer-specific denial reason codes, appeal processes, and timely filing requirements across major commercial payers
• Proven ability to build and lead a collections and denial management team
• Proactive use of AI tools to improve individual output and efficiency

Benefits

• Information about Virta’s benefits is on our Careers page at:

Pay

• Virta uses 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 $117,000 - $135,000.

Schedule

• Virta is a remote-first company with office hubs in Denver and San Francisco.

Company Values

• We put people first and take care of ourselves, our peers, and our patients equally.
• We have a strong sense of ownership and take initiative while empowering others to do the same.
• We prioritize positive impact over busy work.
• We have no ego and understand that everyone has something to bring to the table regardless of experience.
• We appreciate transparency and promote trust and empowerment through open access of information.
• We are evidence-based and prioritize data and science over seniority or dogma.
• We take risks and rapidly iterate.