AnswersNow Inc - Manager of Front-End Revenue Cycle
Requirements
• Knowledge: Comprehensive understanding of medical billing, coding (ICD-10, CPT), and payer rules. Medicaid and commercial plan requirements (Preference for previous work in the following states: Virginia, Georgia, Texas). Strong preference for Applied Behavior Analysis (ABA) Prior Auth experience. • Analytical Skills: 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 • Leadership: Demonstrated experience leading teams in a high-volume, fast-paced environment. Strong administrative, interpersonal, verbal and written communication skills
Responsibilities
• Report directly to VP of Revenue Cycle Management supporting with the following metrics and functions: • Workflow Leadership: 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 • Denial Prevention: 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. • KPI Management: 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. • Team Leadership: Hire, train, and manage staff productivity, providing coaching to ensure compliance with HIPAA and payer policies. Lead, coach, and develop the Credentialing & Licensing team • Cross-Functional Partnerships: 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. • Process Improvement: Develop SOPs and implement new IT systems to improve process efficiency. Design and implement scalable credentialing and enrollment workflows.
Benefits
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