RCM Collections Lead Specialist
Leads a team handling healthcare accounts receivable follow-up and denial resolution while managing a Tier 3 portfolio directly. The role requires 4+ years of RCM collections experience, team mentorship, advanced Excel, payer and coding expertise, and proficiency with healthcare systems.
About the job
Responsibilities
- Lead and develop a team of Collections Specialists, setting daily priorities and holding the team accountable for follow-up cadences and high documentation standards.
- Directly manage a portion of the Tier 3 accounts receivable portfolio, including payer follow-up, denial resolution, and escalation calls.
- Serve as the first point of contact for complex denials, payer disputes, and accounts requiring advanced review or documentation.
- Track team-level AR aging and denial trends, report performance against KPIs, and flag systemic issues with data-supported recommendations.
- Ensure consistent use of productivity scorecards, standardized follow-up templates, and auditable documentation practices.
First 90 Days
- 30 days: Become oriented in RCM platforms and understand the Tier 3 portfolio structure, payer mix, and current aging. Meet the team, understand workflows, and identify coaching opportunities.
- 60 days: Establish productivity expectations and accountability systems for follow-up cadence and documentation. Serve as the escalation point for complex accounts and provide a weekly performance summary.
- 90 days: Identify high-risk patterns in the AR aging queue and develop a targeted action plan. Lead a team-level improvement initiative, such as a payer-specific workflow refresh or training session on recurring denial types.
Requirements
- 4+ years of experience in healthcare revenue cycle management, specializing in collections and accounts receivable follow-up.
- Experience leading, mentoring, or training billing specialists or contractors in an RCM environment.
- Advanced Excel skills, including VLOOKUPs, pivot tables, and data cleaning.
- Expert-level understanding of CPT, HCPCS, and ICD-10 coding; commercial and government payer timely-filing policies; and claim adjudication.
- Proficiency navigating EHRs, clearinghouse platforms, payer portals, and CRM platforms such as Salesforce.
- Ability to remain organized while managing team workload and a personal account portfolio simultaneously.
Nice-to-Haves
- Experience with Athena or Candid Health.
Compensation and Benefits
- Compensation range: $64,500–$83,500 per year.
- Location-based compensation; starting pay depends on qualifications and experience.
- Benefits information is available on Virta Health’s Careers page.
Skills
Revenue Cycle Management, Accounts Receivable, Collections, Denial Resolution, Advanced Excel, Vlookup, Pivot Tables, Cpt, Hcpcs, Icd-10, Ehr, Clearinghouse Platforms, Payer Portals, Salesforce
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