Billing & Contract Specialist Fulltime - Remote at Virta Health

Hundred, West Virginia, United States

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Not SpecifiedCompensation

N/AExperience Level

N/AJob Type

Not SpecifiedVisa

N/AIndustries

Requirements

2-3 years of EMS registration coding and billing experience
2-3 years of Insurance Authorization experience
Understanding of third-party reimbursement and methodologies for all third party payers, especially pre-certification and COB regulations
Working knowledge of MS Excel as well as various PBS related applications or demonstrated computer proficiency

Responsibilities

Prepares, verifies, submits, registers and manages the pre-certification and/or prior authorization process for all applicable patient encounters
Directly manages denied claims working with the insurance companies and Patient Accounting Department
Reviews, audits and reconciles EMS agency invoices, Medicaid trips and prepares requisitions for payment, coordinating with Billing Manager, legal office, Accounts Payable and Purchasing
Reviews invoices from non-Virtua transportation agencies related to interhospital and discharge transport
Audits invoices to ensure proper level of service, insurance authorization and medical necessity
Interacts with Hospital management, and Case Management and Patient Accounting when necessary to approve payment for certain transport
Functions as Department “Keeper of the Records” and interacts with internal HIM and legal staff, external law offices, and patients in the handling and processing of all subpoenas and requests for medical records

Skills

Virta Health

Reverses type 2 diabetes through personalized care

About Virta Health

Virta Health focuses on reversing type 2 diabetes through a combination of personalized nutrition, continuous remote care, and behavioral science. Their treatment is designed for individuals diagnosed with type 2 diabetes, healthcare providers, and enterprise partners like employers and health plans. Unlike many competitors, Virta Health operates on a performance-based model, meaning they only receive payment if they achieve successful outcomes for their patients. This aligns their financial incentives with patient health improvements. The company's goal is to reverse type 2 diabetes in 100 million people, making their approach not just about managing diabetes but actively working towards its reversal.

Denver, ColoradoHeadquarters

2014Year Founded

$362.8MTotal Funding

SERIES_ECompany Stage

Biotechnology, HealthcareIndustries

501-1,000Employees

Benefits

Remote-first work environment

Flexible work hours & time off policy

Health insurance

Paid parental leave

Free Virta treatment & family discount

Internet, home office, learning & development stipends

Employee resource groups

401K & ROTH contribution

Risks

Increased competition in diabetes reversal could threaten Virta's market share.

Rising popularity of GLP-1 medications may divert clients from Virta's approach.

Regulatory changes in GLP-1 prescriptions could impact Virta's business model.

Differentiation

Virta Health offers a medication-free approach to reversing type 2 diabetes.

Their performance-based model aligns financial incentives with patient outcomes.

Virta's continuous remote care platform provides personalized nutrition and behavioral support.

Upsides

Virta Health has achieved over $100M in annualized revenue with sustainable weight loss solutions.

Partnerships with major payers like U-Haul enhance Virta's market reach and credibility.

Growing skepticism about GLP-1 medications boosts demand for Virta's alternative treatments.

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