Front End Revenue Cycle Manager

Job Summary

Managing the accuracy and timeliness of upstream revenue cycle activities, the full-time Front End Revenue Cycle Manager will oversee member eligibility, claims entry, and provider credentialing processes remotely to ensure efficient billing operations.

Key responsibilities

• Own the end-to-end member eligibility process, including verification of active insurance coverage and managing discrepancies
• Oversee claims preparation and submission, ensuring accuracy and compliance with payer-specific requirements
• Manage provider credentialing and enrollment to ensure all providers are properly credentialed before service delivery

Required qualifications

• 5+ years of revenue cycle management experience focused on front-end functions such as eligibility, claims entry, and credentialing
• Strong knowledge of ANSI X12 EDI transactions, including 270/271, 837, and 835
• Experience with Athena Health or similar practice management/claims systems
• Demonstrated ability to manage cross-functional relationships in a healthcare setting
• Proven experience in healthcare technology, digital health, or value-based care environments preferred