Manager of Front-End Revenue Cycle

Role Overview

Manager of Front-End Revenue Cycle (Full-time, remote)

You will lead the authorization and front-end revenue cycle team to secure and maintain payer approvals for clinical services (ABA). The goal is to ensure continuity of care by minimizing authorization delays and maximizing approval rates.

Responsibilities

• Workflow leadership: Own front-end operations including registration, benefits verification, medical documentation, and prior authorization.
• Credentialing & payer onboarding: Own credentialing systems, vendors, and tools including CAQH, NPPES, payer portals, and internal platforms.
• Denial prevention: Analyze root causes of rejections/edits; implement corrective actions to minimize denials.
• Payer enrollment & contracting: Own payer enrollment and credentialing activities; coordinate payer contracting submissions.
• Credentialing reviews: Oversee review/validation of practitioner applications.
• KPI management: Track metrics such as clean claim rates, insurance verification accuracy, and charge lag; provide executive updates on performance and operational risks.
• Team leadership: Hire, train, and manage staff productivity; coach for compliance with HIPAA and payer policies.
• Cross-functional partnerships: Collaborate with clinical teams and back-end RCM/billing to improve cash flow and revenue acceleration.
• Process improvement: Develop SOPs and implement IT systems; design scalable credentialing and enrollment workflows.

Requirements

• 3–5+ years of healthcare revenue cycle experience, specifically front-end workflows (scheduling, verification, authorization).
• Strong understanding of medical billing and coding: ICD-10 and CPT, plus payer rules.
• Experience with payer requirements (Medicaid and commercial), with a preference for prior work in Virginia, Georgia, or Texas.
• Strong preference for ABA prior authorization experience.
• Proficiency using data, dashboards, and reporting tools to identify trends and process gaps.
• Google Suite proficiency (Docs, Sheets, Drive, Forms, Slides).
• Demonstrated leadership experience in a high-volume, fast-paced environment.
• Strong communication skills (verbal and written) and strong administrative/interpersonal skills.

Nice to Have

• Prior proficiency with care management and RCM platforms (prior auth portals, EMRs, billing platforms).
• Prior experience working in payer enrollment/credentialing and payer contracting submission.