Manager of Front-End Revenue Cycle
A
AnswersNow IncHealthcare
Remote, Anywhere in the USFull-TimeManager
Salary80,000 - 90,000 USD per year
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Job Details
- Experience
- 3–5+ years
- Required Skills
- Google SheetsGoogle Workspace
Requirements
- 3–5+ years of healthcare revenue cycle experience, specifically with front-end workflows (scheduling, verification, authorization)
- Proficiency in care management and RCM platforms (prior auth portals, EMRs, billing platforms)
- Comprehensive understanding of medical billing, coding (ICD-10, CPT), and payer rules
- Knowledge of Medicaid and commercial plan requirements (preference for Virginia, Georgia, Texas)
- Applied Behavior Analysis (ABA) Prior Auth experience (strong preference)
- Proficient in using data, dashboards, and reporting tools
- Proficiency with Google Suite (Docs, Sheets, Drive, Forms, Slides)
- Demonstrated experience leading teams in a high-volume, fast-paced environment
- Strong administrative, interpersonal, verbal and written communication skills
Responsibilities
- Lead all front-end operations, including registration, benefits verification, medical documentation, and prior authorization.
- Own credentialing systems, vendors, and tools including CAQH, NPPES, payer portals, and internal platforms.
- Analyze root causes of rejections and edits to implement corrective actions and minimize denials.
- Own payer enrollment and credentialing activities and coordinate payer contracting submission.
- Oversee the review and validation of practitioner applications.
- Monitor key performance indicators (KPIs) such as clean claim rates, insurance verification accuracy, and charge lag.
- Provide regular executive-level updates on credentialing performance, priorities, and operational risks.
- Hire, train, and manage staff productivity, providing coaching to ensure compliance with HIPAA and payer policies.
- Lead, coach, and develop the Credentialing & Licensing team.
- Collaborate with clinical, back-end RCM, and billing teams to improve cash flow and revenue acceleration.
- Partner closely with Provider Onboarding and Growth teams to ensure all required documentation is collected promptly and credentialing is initiated without delay.
- Develop SOPs and implement new IT systems to improve process efficiency.
- Design and implement scalable credentialing and enrollment workflows.
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