RCM Front End Lead Specialist

As a Front End Lead Specialist, you play a critical role in the success of Virta’s revenue cycle operations. You’ll own complex client billing configurations and ensure every billing process is executed with accuracy, consistency, and care. You’ll also oversee and manage Data and Charge Entry contractors, ensuring all billing data, charge reconciliations, and claim submissions are accurate, complete, and aligned with operational timelines. This role is ideal for a seasoned individual contributor who thrives on problem-solving, collaboration, and continuous improvement.

Responsibilities

Lead and oversee the configuration and setup of new client billing accounts, ensuring full operational readiness and accuracy; Partner with cross-functional teams (Engineering, Credentialing, Eligibility, Finance) to ensure seamless onboarding and payment setup; Maintain and evolve documentation for onboarding, configuration, and customer contract updates; Own and maintain the Price Book, ensuring accuracy across all billing and payer setups; Lead and complete billing testing to validate configurations and prevent downstream issues; Interpret and apply eligibility, benefit, and coding details (CPT, HCPCS, ICD-10) to ensure compliance and precision in all setups; Serve as a key contributor in scaling implementation processes—developing documentation, recommending automation, and improving workflows; Serve as a subject matter expert (SME) for front-end RCM processes and system integrations; Oversee and manage Data and Charge Entry contractors and FTEs supporting team direction and deliverables; Lead small-to-medium process improvement projects focused on automation, accuracy, and scalability; Drive enhancements across platforms such as Athena, Zuora, and Salesforce, ensuring downstream billing logic remains accurate; Mentor and support junior team members and contractors, sharing institutional knowledge, reviewing work, and modeling effective communication and problem-solving; Communicate proactively, constructively resolving differences and aligning stakeholders through documentation, clear updates, and collaborative planning.

Requirements

3–5+ years of experience in healthcare revenue cycle management, including direct billing and payer implementations; Proven success managing complex accounts, handling escalations, and resolving exceptions with professionalism and clarity; Experience overseeing and managing Data and Charge Entry contractors, ensuring accuracy across charge entry, reconciliation, billing data, and related operational workflows; Advanced understanding of commercial and government payer policies, reimbursement methodologies, contract requirements, and CPT, HCPCS, and ICD-10 coding; Experience leading small projects or process improvement initiatives, with the ability to analyze data, identify trends, and build reporting frameworks that drive operational decision-making; Strong technical proficiency with Athena, Zuora, Salesforce, and JIRA (or similar RCM systems), along with excellent communication skills and a collaborative, solutions-focused mindset; Demonstrates a proactive use of AI tools to improve individual output and efficiency.

Nice to have

Familiarity with product development or systems optimization