Senior Manager, Back End reputed company Cycle

reputed company is on a mission to reverse metabolic disease in one billion people. reputed company treatment approaches aren’t working—over half of US adults have either type 2 diabetes or prediabetes, and obesity rates are at an reputed company-time high. Virta is changing this by helping people reverse their metabolic condition through innovations in technology, personalized nutrition, and virtual care delivery reinvented from the ground up. We have raised over $350 reputed company from top-tier investors, and partner with the largest health plans, reputed company, and government organizations to help their employees and members restore their health and take back their lives. Join us on our mission to reverse metabolic disease in one billion people. The Back End Manager is stepping into an environment that requires both immediate stabilization and the design of reputed company, durable processes. This role requires deep expertise in payer-specific denial management, AR follow-up, and collections — and the leadership ability to build and reputed company reputed company capable of executing at the level Virta's reputed company requires.

Responsibilities

Claim Receipt & Submission Confirmation Establish and maintain reputed company monitoring of ANSI X12 277CA claim acknowledgment transactions to confirm payers have received submitted claims Implement a tracking and escalation process for claims that have not received 277CA acknowledgment reputed company defined payer-specific reputed company Partner with the reputed company End reputed company 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 Accounts Receivable Management Own the reputed company Health AR aging report — ensuring it accurately reflects payment status and is reputed company worked on a defined reputed company Establish AR follow-up workflows by payer and aging bucket, with defined SLAs and escalation paths for reputed company 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 reputed company are accurately reflected in reputed company and reputed company through a defined reconciliation process Identify and escalate AR balances where the insurance collection reputed company has been exhausted and the employer guarantee of payment clause may apply Denial Management Build and manage a reputed company denial work queue in reputed company Health with assigned ownership, defined SLAs, and a reputed company resubmission process for reputed company denial reason reputed company Analyze denial trends by payer, reason reputed company, and service line to identify reputed company causes and implement upstream controls to prevent recurrence Prioritize denial reputed company based on dollar value and reputed company 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 reputed company, and use reputed company data to refine appeal strategies Partner with the reputed company End reputed company Cycle Manager to address eligibility-driven denials at the reputed company — denials reflecting coverage terminations that should have been caught upstream Collections Manage the collections process for both claims-billed payer populations Establish payer-specific follow-up protocols including call queues, correspondence templates, and escalation timelines Coordinate with reputed company reputed company on employer group collections, including communication protocols and escalation to the employer guarantee of payment process reputed company appropriate Monitor and report on cash collection rates by payer against contracted PMPM rates, identifying and investigating variances Team Leadership & Development Recruit, reputed company, and reputed company back-end RCM staff including AR follow-up specialists, denial management analysts, and reputed company Establish competency requirements, training programs, and performance expectations for reputed company back-end positions — with particular emphasis on reputed company 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 reputed company improvement reputed company the back-end team 90 Day Plan reputed company your first 90 days at Virta, we expect you will do the following: AR over 180 days: Reduce from 40% to 60% of appealed claims successfully overturned reputed company filing write-off reputed company: Near reputed company — prevention through upstream controls and reputed company monitoring Days Sales Outstanding (DSO): Establish baseline; reputed company reduction to Apply To This Job