Virta is the first company with a clinically-proven treatment to safely and sustainably reverse type 2 diabetes and other chronic metabolic diseases 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 - to reverse type 2 diabetes in 100 million people by 2025.
Virta has an outcomes based pricing model and we are only paid when our patients achieve critical health outcomes (reduced HbA1c, weight loss, medication reduction). The Revenue Cycle Manager plays an integral role in keeping our business running and achieving our goal of being paid based on outcomes.
The revenue cycle manager will sit on our Finance team and report into the Senior Accounting Manager.
- Accelerating our cash collections + other key claims KPIs (Claims Charge Lag, Denial Rates, Clean Claim Rates etc.)
- Coordinating with our sales and CS teams on upcoming customer deals/launches that require claims billing & ensuring that customer requirements are being fulfilled
- End to end claims revenue cycle transformation projects including:
- Documentation and coding (optimizing codes we are currently billing, expertise in FFS billing and telehealth codes)
- Claims submission and management
- Denials and A/R management
- Collections and payment posting
- Reporting and metrics
- Driving cross functional claims issues management across CS, sales, product and engineering
- Implementing a new revenue cycle management system
- Partnering with the Engineering, Product and Operations teams to continue to introduce automation to our claims billing processes
- Ability to present to external clients as the billing subject matter expert in support of customer success and sales
- Defining best practices for submitting claims to all insurance carriers Virta works with; maximizing for revenue collection and scalability
- Partner with commercial and operations teams to build and scale fee for service opportunities
90 Day Plan
Within your first 90 days at Virta, we expect you will do the following:
- Implement and manage a third party revenue cycle management software vendor
- Identify and implement resolutions for existing issues impacting claims billing; defining Virta’s claim submission policies and procedures to avoid future issues
- Identify areas for process/systems optimization to drive cash KPIs
- Build reporting and tracking for the end to end claims process from submission to payment receipt
- Develop and measure a Cash Collection KPI
- 5 years of revenue cycle management experience at a medical group. Working knowledge of the practices, procedures, and concepts of the healthcare revenue cycle; knowledge of any or all of the following: billing, collections, charge capture, contractual adjustments, third-party reimbursements, and cash management
- Expertise with payor policies and processes related to coding and claims billing
- Fundamental understanding of coding (CPT and ICD-10) and documentation requirements (for both billing and compliance), and the billing submission process. Expertise with fee for service billing/coding & telehealth coding/billing.
- Strong attention to detail and problem-solving skills
- Degree in accounting, finance or business preferred, but not required
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.