Lead all front-end revenue cycle operations including benefits verification, authorization, coding, charge entry, and rejection/edit resolution.
Set front-end strategy, KPIs, performance standards, and operating cadence to support clean claim submission and payer compliance.
Design, implement, and maintain workflows, SOPs, and escalation paths across all front-end functions and tiers.
Allocate work and manage capacity to meet daily throughput expectations and service-level turnaround times.
Drive root-cause analysis for rejections, edits, and coding errors; implement corrective actions, training, and upstream fixes.
Partner with the Back-End RCM Manager to close the loop on denial prevention, trend analysis, and cash acceleration initiatives.
Monitor payer policies, medical necessity rules, and regulatory changes; update processes, playbooks, and guidance accordingly.
Ensure compliance with HIPAA, payer requirements, medical necessity, and documentation standards.
Lead audit readiness and support internal and external audits related to front-end RCM functions.
Drive continuous improvement initiatives through data analysis, reporting, and performance management.
Communicate risks, progress, and outcomes to leadership and cross-functional stakeholders.
Manage staffing models, cross-coverage, and productivity across front-end teams.
Perform other related duties as assigned.

Bachelor’s degree in Business Administration, Healthcare, or related field preferred.
5+ years of healthcare or revenue cycle management experience, including demonstrated leadership responsibility.
Demonstrated experience with KPI development, financial analysis, and performance improvement initiatives.
Extensive knowledge of medical billing, coding (ICD-10, CPT, HCPCS), and end-to-end revenue cycle workflows.
Strong understanding of payer rules, denial management, appeals, and reimbursement methodologies.
Proven ability to partner with client-facing teams and communicate effectively with internal and external stakeholders.
Professional demeanor with strong written, verbal, and interpersonal communication skills.

Flexibility to work where/how you want within your country of employment – in-office, remote, or hybrid
Continued investment in your professional development
Day 1 access to a robust health and wellness benefits package, including an annual wellness stipend.
401k with up to a 4% match and immediate vesting
Flexible and generous (FTO) time-off
Employee Stock Purchase Program

RCM Manager, Front End

Key skills