Manager of Front-End Revenue Cycle

AnswersNow Inc

2d•Remote

About The Position

The Manager of Front-End Revenue Cycle leads the authorization team responsible for securing and maintaining payer approvals for clinical services (ABA Services). This role ensures continuity of care by minimizing authorization delays and maximizing approval rates.

Requirements

3–5+ years of healthcare revenue cycle experience, specifically with front-end workflows (scheduling, verification, authorization).
Proficiency in care management and RCM platforms (i.e. 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.
Applied Behavior Analysis (ABA) Prior Auth experience.
Proficient in using data, dashboards, and reporting tools to identify trends and process gaps.
Proficiency with Google Suite (e.g., Docs, Sheets, Drive, Forms, Slides) required.
Demonstrated experience leading teams in a high-volume, fast-paced environment.
Strong administrative, interpersonal, verbal and written communication skills.

Nice To Haves

Proficiency in care management and RCM platforms (i.e. prior auth portals, EMRs, billing platforms).
Previous work in the following states: Virginia, Georgia, Texas.
Applied Behavior Analysis (ABA) Prior Auth experience.

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.