Credentialing & Revenue Cycle Manager

Mochi Health • San Francisco, CA

19d • Onsite

About The Position

Mochi Health is building an AI-driven marketplace to make healthcare discoverable, connecting patients to the right providers, transparent pharmacy pricing, and affordable medications. The company is growing rapidly by combining clinical expertise with technology. Their platform offers patients transparent pricing, personalized medication management, and long-term access to medical records. Mochi Health is looking for individuals who value bold thinking, inclusive collaboration, and meaningful work. This is a full-time, onsite role requiring 5 days/week in the office. As the Manager of Credentialing & Revenue Cycle, you will be responsible for provider credentialing and payer enrollment across a multi-state provider network, and for building the necessary billing infrastructure to support reimbursement at scale. This is a builder role where you will design workflows, select tooling, and establish processes for revenue generation from clinical care. You will report to the Head of Operations and collaborate with clinical ops, insurance ops, and product/engineering teams.

Requirements

• 3-5 years of experience in provider credentialing, revenue cycle management, or insurance operations.
• Meaningful experience in health tech or telehealth, including building or scaling workflows in a fast-moving environment.
• Has built or rebuilt a credentialing or RCM function, not just inherited one.
• Hands-on experience with RCM and billing platforms (Candid or equivalent), credentialing management tools, and practice management systems.
• Expert-level proficiency navigating major commercial payer portals (Availity, UnitedHealthcare Link, NaviNet) to audit claim statuses, track down stuck remittances, and resolve complex multi-network denials outside automated billing workflows.
• Solid working knowledge of E&M coding, CPT/ICD-10, and CMS billing and telehealth billing guidelines.
• Comfortable using and evaluating AI tools and automation platforms; has incorporated these into actual workflows.
• Has managed a small team and can develop people while staying hands-on.
• Strong communicator who can translate complex billing or credentialing issues into clear operational plans and executive summaries.

Nice To Haves

• Experience with multi-entity or multi-state provider networks.
• Background in direct primary care or GLP-1/metabolic telehealth.
• CPMSM, CPCS, or CRCR certification.
• Experience owning or supporting prior authorization workflows and payer escalation processes.

Responsibilities

• Manage end-to-end provider credentialing and payer enrollment across multiple states and medical entities.
• Maintain credentialing timelines and payer enrollment status across the provider network.
• Coordinate with medical directors and credentialing bodies on initial and re-credentialing cycles.
• Support payer contracting and in-network participation strategy as care programs expand.
• Own the operational buildout of E&M billing for the Wellness Plus program, from claim submission through payment reconciliation.
• Partner with coding, clinical, and finance teams to ensure accurate CPT and ICD-10 documentation and submission.
• Monitor denial trends, conduct root cause analysis, and implement corrective workflows.
• Build and maintain reporting on key RCM metrics: denial rate, days in AR, clean claim rate, net collection rate.
• Actively integrate AI-assisted tools into credentialing and RCM workflows, including prior authorization support, coding suggestion tools, and payer portal automation.
• Identify high-volume manual processes that can be reduced through automation and partner with product and engineering to scope and ship improvements.
• Evaluate new health tech tooling as the landscape evolves and bring informed recommendations to the team.
• Manage and develop a small team supporting credentialing and RCM operations.
• Partner with insurance ops, pharmacy ops, and clinical ops on overlapping workflows.
• Serve as the internal subject matter expert on payer policies, E&M billing requirements, and credentialing compliance.

Benefits

• All meals catered – five days a week, breakfast, lunch and dinner professionally catered.
• On-site Barista with unlimited espresso and matcha.
• Transportation benefits.
• 401(k) match.
• Unlimited PTO.
• Fully covered life insurance.
• Medical, dental and vision insurance.
• Generous equity package.

What This Job Offers

• Job Type: Full-time
• Career Level: Manager
• Education Level: No Education Listed