Revenue Cycle Manager

We are seeking a Revenue Cycle Manager to oversee the end‑to‑end revenue cycle operations for our clinics, from patient insurance verification and prior authorization through claims submission, denial management, and collections. This role is critical to ensuring accurate billing, efficient claims processing, provider engagement and timely reimbursements. In addition to traditional revenue cycle management responsibilities, this position requires hands‑on expertise in mental health billing as well as experience working on third‑party insurance verification, prior authorization, and revenue cycle management tools and systems. Location Hybrid – preferred in‑office Monday–Wednesday at our San Mateo headquarters, with flexibility to work remotely for candidates in California. Key Responsibilities Insurance Verification & Prior Authorization Verify patient insurance eligibility and benefits prior to service delivery, including confirming coverage for mental health and specialty services (TMS, Spravato, IOP). Prepare, submit, and track prior authorization requests with payers, ensuring timely approvals before treatment begins. Follow up on pending and denied prior authorizations, escalating to payers as needed. Maintain an organized tracking system for authorization statuses, expiration dates, and renewal deadlines. Coordinate with clinical staff to gather required supporting documentation (clinical notes, treatment plans) for authorization submissions. Billing & Claims Management Accurately prepare, review, and verify CMS‑1500 claim forms for submission. Ensure compliance with payer guidelines, coding requirements, and regulatory standards. Automate billing processes and coding in conjunction with our technology team. Setup and operate third‑party tools to facilitate billing, claims submission and analytics. Revenue Cycle Oversight Manage all aspects of the revenue cycle, including charge capture, claims submission, payment posting, denial management, and patient collections. Monitor KPIs such as days in A/R, denial rates, and collections, providing regular reports to leadership. Prepare and present key RCM data and insights to broader team. Develop and implement processes to optimize cash flow and minimize errors. Reconcile differences with Finance & Accounting team. Track, categorize, and analyze claim denials to identify root causes and trends. Manage the denial appeals process, including preparing and submitting appeal letters with supporting documentation within payer‑required timelines. Implement corrective actions to reduce denial rates (e.g., improving front‑end verification, coding accuracy, or authorization compliance). Collaboration & Communication Collaborate with clinic operations team to set up scalable and sustainable revenue cycle operations practices. Serve as the primary liaison between the clinic and third‑party billing company. Collaborate with providers and clinical staff to ensure accurate documentation, coding and denials management. Required Qualifications Bachelor’s degree in Healthcare Administration, Business, Accounting, or related field. 3–5 years of experience in medical billing and revenue cycle management, preferably in an outpatient or small clinic setting. Strong knowledge of medical billing, CPT coding, insurance verification, and payer requirements. Hands‑on experience preparing and verifying CMS‑1500 claim forms. Excellent organizational skills, attention to detail, and ability to manage multiple priorities. Strong communication and problem‑solving skills, with experience coordinating with providers and external vendors. Demonstrated experience managing prior authorization workflows, including submission, follow‑up, and appeals. Familiarity with payer‑specific authorization requirements for behavioral health services. Preferred Qualifications Experience in behavioral health billing specifically TMS, Spravato and IOP. Experience with facility billing (UB‑04, CMS‑1450). Experience with eligibility verification tools or clearinghouses (e.g., Availity, Waystar). Knowledge of Medicare/Medicaid authorization requirements for behavioral health. Compensation & Benefits The compensation for this position includes: Base Salary: $100,000 – $130,000, depending on experience, qualifications, and location. Benefits: Medical, dental, vision, PTO, and additional benefits. We reserve the right to modify benefit offerings at any time, in accordance with applicable laws. Work Authorization Sponsorship for employment authorization may be considered on a case‑by‑case basis depending on the role and candidate qualifications. Equal Opportunity & Accessibility Statement We are committed to providing a workplace that is inclusive, respectful, and free from discrimination. We welcome applicants of all backgrounds and make employment decisions without regard to race, color, religion, sex (including pregnancy, childbirth, and related medical conditions), sexual orientation, gender identity or expression, national origin, ancestry, citizenship, age, physical or mental disability, medical condition, genetic information, marital status, military or veteran status, or any other characteristic protected by California or federal law. In accordance with the California Fair Chance Act, we will consider qualified applicants with arrest and conviction records. Accessibility If you require a reasonable accommodation during the application or hiring process, please contact us directly – we’re happy to help. #J-18808-Ljbffr