Senior Manager, Back End Revenue Cycle

Virta Health is on a mission to reverse metabolic disease in one billion people. Current treatment approaches aren’t working—over half of US adults have either type 2 diabetes or prediabetes, and obesity rates are at an all-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 million from top-tier investors, and partner with the largest health plans, employers, 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 scalable, durable processes. This role requires deep expertise in payer-specific denial management, AR follow-up, and collections — and the leadership ability to build and develop a team capable of executing at the level Virta's growth requires. RESPONSIBILITIES Claim Receipt & Submission Confirmation - Establish and maintain active 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 within defined payer-specific windows - Partner with the Front End Revenue 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 Athena Health AR aging report — ensuring it accurately reflects payment status and is actively worked on a defined cadence - Establish AR follow-up workflows by payer and aging bucket, with defined SLAs and escalation paths for each 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 Athena are accurately reflected in Zuora and NetSuite through a defined reconciliation process - Identify and escalate AR balances where the insurance collection path has been exhausted and the employer guarantee of payment clause may apply Denial Management - Build and manage a structured denial work queue in Athena Health with assigned ownership, defined SLAs, and a clear resubmission process for each denial reason code - Analyze denial trends by payer, reason code, and service line to identify root causes and implement upstream controls to prevent recurrence - Prioritize denial resolution based on dollar value and timely 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 code, and use outcomes data to refine appeal strategies - Partner with the Front End Revenue Cycle Manager to address eligibility-driven denials at the root — 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 Client Success on employer group collections, including communication protocols and escalation to the employer guarantee of payment process when appropriate - Monitor and report on cash collection rates by payer against contracted PMPM rates, identifying and investigating variances Team Leadership & Development - Recruit, onboard, and develop back-end RCM staff including AR follow-up specialists, denial management analysts, and colle