As a Collections Senior Specialist, you play a vital role in optimizing Virta’s revenue cycle by owning complex payer relationships, driving denials management, and ensuring timely and accurate reimbursement. You’ll oversee contractor performance, lead improvement projects, and provide mentorship to Collections Specialists, modeling excellence in accuracy, follow-through, and professionalism.This position is ideal for a proactive, analytical, and collaborative individual who thrives on solving complex billing challenges and driving measurable results.As a Collections Lead Specialist, you are responsible for leading Virta’s denials management and collections operations, ensuring financial accuracy, process consistency, and proactive payer engagement across the revenue cycle. You’ll manage a team of Collections Specialists and contractors, develop data-driven collection strategies, and oversee reporting to meet department KPIs.This role is ideal for an experienced revenue cycle professional who combines strong analytical expertise with operational leadership, team coaching, and cross-functional collaboration. You’ll balance tactical execution with strategic oversight to drive cash collections, reduce aged A/R, and improve payment performance across all payer lines.<h1>🔑 Key Responsibilities</h1><h2>Revenue Cycle Leadership</h2><ul><li>Lead, manage, and develop a team of Collections Specialists (FTEs) and contractors, ensuring alignment on daily priorities, quality standards, and departmental goals.</li><li>Set clear expectations and create accountability systems for follow-up timeliness, documentation accuracy, and resolution outcomes.</li><li>Conduct regular team meetings to review performance metrics, address payer challenges, and identify areas of opportunity.</li><li>Provide feedback, coaching, and mentorship to elevate team capability and professional growth.</li><li>Partner with RCM leadership to establish team-wide A/R reduction goals, ensuring consistent progress across all payer portfolios.</li><li>Monitor daily operations and proactively remove blockers to maintain momentum and results.</li><li>Celebrate achievements and recognize team contributions while fostering an environment of collaboration and accountability.</li><li>Participate in workforce planning, recruitment, and onboarding to build a high-performing collections team. </li></ul><h2>Denials &amp; A/R Follow-Up</h2><ul><li>Oversee all denials management and A/R follow-up processes, ensuring timely resolution of outstanding claims and underpayments.</li><li>Conduct and facilitate payer meetings and escalation discussions to expedite claim resolution and maintain strong payer relationships.</li><li>Ensure adherence to standard follow-up cadence and documentation practices across the team and contractors.</li><li>Review and approve corrected or resubmitted claims to ensure accuracy and compliance with payer requirements.</li><li>Monitor and report on denial trends, A/R aging, and turnaround times (TAT); drive actions to improve key metrics.</li><li>Ensure the team proactively updates test claim stats, payer worklists, and aging reports.</li><li>Lead efforts to prevent growth in &gt;90-day A/R, promoting accountability for consistent aging reduction.</li><li>Collaborate with cross-functional teams (Eligibility, Credentialing, Product, Front End RCM) to address systemic issues impacting claim payment.</li><li>Escalate payer issues with data-supported documentation, including notes, outreach history, and recommendations.</li><li>Oversee and review contractor activities to ensure completeness, timeliness, and compliance with Virta’s standards. </li></ul><h2>Productivity &amp; Reporting</h2><ul><li>Own team-level Denials &amp; A/R Productivity Scorecards, ensuring all specialists and contractors maintain accurate, timely entries.</li><li>Track and evaluate performance against departmental KPIs (e.g., denial resolution rate, A/R aging reduction, turnaround time).</li><li>Produce weekly and monthly summaries on collections performance, payer trends, and outstanding issue escalations.</li><li>Ensure all tracking tools and reports are completed consistently across the team using standardized templates.</li><li>Partner with leadership to refine productivity and performance dashboards that drive transparency and continuous improvement.</li><li>Collaborate with Finance and Accounting to reconcile A/R data and verify accurate cash postings.</li><li>Review team documentation to confirm proper follow-up frequency, accuracy, and compliance.</li><li>Encourage data-driven decision making and use insights to refine payer strategies and workload allocation. </li></ul><h2>Process Improvement &amp; Cross-Functional Collaboration</h2><ul><li>Lead medium-to-large scale improvement projects focused on denials prevention, automation, and A/R efficiency.</li><li>Identify and implement process improvements that streamline workflows, improve turnaround times, and enhance reporting accuracy.</li><li>Partner with Product, Engineering, and Analytics to resolve recurring claim issues and strengthen system integrations.</li><li>Develop, document, and maintain standard operating procedures (SOPs) and reference guides for the collections function.</li><li>Participate in enterprise-level initiatives, representing the collections function in RCM and cross-departmental workgroups.</li><li>Surface valuable insights and communicate actionable recommendations to management and other stakeholders.</li><li>Create content and documentation that captures best practices, enabling consistent training and process adoption across the team. </li></ul><h2>Mentorship &amp; Knowledge Leadership</h2><ul><li>Serve as a subject matter expert (SME) in collections, denials management, and payer relations.</li><li>Provide formal and informal coaching to team members and contractors, promoting consistent execution and professional growth.</li><li>Lead group training sessions and share knowledge across the RCM department to strengthen collective expertise.</li><li>Communicate effectively, maintaining transparency, constructive feedback, and alignment within the team and across functions.</li><li>Support the creation of an inclusive, performance-driven culture where individuals are motivated, recognized, and supported. </li></ul><h1>🚀 90 Day Plan</h1>Within your first 90 days at Virta, you will:<ul><li>Master navigation and reporting across all RCM platforms (Athena, Zuora, Salesforce, Spark, JIRA).</li><li>Gain a deep understanding of payer relationships, aging reports, and current collections workflows.</li><li>Establish clear productivity and reporting expectations for your team and contractors.</li><li>Build strong cross-functional partnerships with Front End RCM, Credentialing, Product, and Finance teams.</li><li>Lead one cross-functional project aimed at improving denials management or A/R reduction processes.</li><li>Identify and communicate early wins, risks, and opportunities to leadership.</li><li>Present an action plan for optimizing team performance and reducing aging A/R within the first quarter. </li></ul><h1>🎓 Requirements</h1><ul><li>5–7+ years of experience in healthcare revenue cycle management, denials management, or collections.</li><li>2+ years of experience leading teams (including both FTEs and contractors) in an RCM or billing environment.</li><li>Proven success driving measurable improvements in A/R reduction, denials resolution, and payer turnaround times.</li><li>Strong expertise in CPT, HCPCS, and ICD-10 coding and claims adjudication.</li><li>Deep understanding of commercial and government payer rules, appeals processes, and compliance requirements.</li><li>Demonstrated ability to lead medium-to-large projects that improve billing performance and automation.</li><li>Exceptional analytical skills with a data-driven approach to decision making.</li><li>Strong communication, presentation, and people leadership skills.</li><li>Proficiency in Athena, Zuora, Salesforce, JIRA, or comparable RCM systems.</li><li>Strategic mindset with the ability to balance speed, quality, and long-term sustainability. </li></ul><h1>💙 Values-driven culture</h1>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 Virtas security and privacy procedures to ensure our patients information remains strictly confidential. Security and privacy training will be provided.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 Virtas security and privacy procedures to ensure our patients information remains strictly confidential. Security and privacy training will be provided.As a remote-first company, our team is spread across various locations with office hubs in Denver and San Francisco. Clinical roles: We currently do not hire in the following states: AK, HI, RI Corporate roles: We currently do not hire in the following states: AK, AR, DE, HI, ME, MS, NM, OK, SD, VT, WI.#LI-remote

Virta Health

RCM - Collections Lead Specialist

Virta Health