Manager, Front End Revenue Cycle

🕒 June 8

🐻 Alaska, Hawaii, +7 more states – Remote

🐻 Alaska – Remote 🌺 Hawaii – Remote 🦞 Maine – Remote 🌶️ New Mexico – Remote 🌪️ Oklahoma – Remote 🎸 Mississippi – Remote 🗿 South Dakota – Remote 🍁 Vermont – Remote 🧀 Wisconsin – Remote

💵 $93k - $107k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

💻 Frontend Engineer / Web Developer

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Virta Health

WebsiteLinkedInAll Job Openings

201 - 500 employees

⚕️ Healthcare Insurance

🧘 Wellness

Healthcare Insurance • Wellness • Health Tech

Virta Health is a healthcare company focused on reversing type 2 diabetes and promoting sustainable weight loss through a nutrition-first approach. The company offers personalized treatment plans that help individuals reduce or eliminate the need for diabetes medications. Virta collaborates with organizations and healthcare providers to deliver transformative outcomes in metabolic care. Their approach is evidence-backed, emphasizing the importance of lifestyle and dietary changes to achieve lasting health improvements and weight management.

📋 Description

• Own the end-to-end member eligibility process — from receipt of client eligibility files through verification of active insurance coverage in Athena Health • Define and enforce client eligibility file completeness standards; establish intake SLA with Client Success for incomplete or missing demographic and insurance data • Implement and manage real-time eligibility (RTE) verification (using ANSI X12 270/271) transactions to confirm active coverage before claims are submitted • Develop and maintain a reconciliation process to ensure all active members in Zuora have corresponding verified records in Athena • Identify and resolve eligibility discrepancies, retroactive terminations, and coverage changes before they result in denied claims or revenue loss • Monitor eligibility-related denial trends and implement upstream controls to reduce recurrence • Oversee the accuracy and completeness of claims preparation and entry across all Virta Health products — Diabetes Reversal, Diabetes Management, and Sustainable Weight Loss • Ensure all claims are coded correctly and submitted within payer-specific timely filing windows • Monitor claim submission lag — the time between billing period close and claim submission — and establish benchmarks to reduce exposure • Work with Engineering to improve the flow of billing trigger data from Spark into Athena, reducing manual intervention in claims entry • Implement pre-submission claim scrubbing processes to improve clean claim rates and reduce first-pass rejections • Maintain working knowledge of CPT, HCPCS, and ICD-10 coding requirements relevant to Virta Health's digital health and value-based care model • Manage provider and program credentialing and payer enrollment for all applicable Virta Health providers, locations, and product lines • Ensure all providers are enrolled with payers prior to service delivery to prevent claim denials related to credentialing status • Maintain a credentialing tracking system with defined renewal timelines, expiration alerts, and re-credentialing workflows • Coordinate with Legal, HR, and Clinical Operations on provider onboarding and payer network participation requirements • Recruit, onboard, and develop front-end RCM staff including eligibility specialists, claims entry staff, and credentialing coordinators • Establish role-specific SOPs, training programs, and performance expectations for all front-end positions • Conduct regular performance reviews and provide coaching to develop staff competency in eligibility verification, coding, and claims entry • Partner with the Manager/Director of Operational Effectiveness on reporting and process improvement initiatives affecting front-end functions.

🎯 Requirements

• 5+ years of revenue cycle management experience with a focus on front-end functions — eligibility, claims entry, and/or credentialing • Strong working knowledge of ANSI X12 EDI transactions including 270/271 (eligibility), 837 (claims), and 835 (remittance) • Experience with Athena Health or comparable practice management/claims system • Demonstrated ability to manage cross-functional relationships with Client Success, Engineering, and clinical teams • Experience in healthcare technology, digital health, or value-based care environments preferred • Demonstrates a proactive use of AI tools to improve individual output and efficiency.

🏖️ Benefits

• Offers Equity