Credentialing & Revenue Cycle Manager
$130,000–$160,000 year
On-site · San Francisco, California, United States
Job Summary
Manager of Credentialing & Revenue Cycle at Mochi Health, owning provider credentialing and payer enrollment across a multi-state provider network and building the billing infrastructure needed to support reimbursement at scale. Responsibilities include end-to-end credentialing, payer enrollment, maintaining timelines, coordination with credentialing bodies, and supporting payer contracting; revenue cycle management for E&M billing, CPT/ICD-10 documentation and submission, denial trend analysis, and reporting on key metrics. The role also requires integrating AI-assisted tools into credentialing and RCM workflows, identifying high-volume manual processes for automation, and leading a small team while collaborating with clinical ops, insurance ops, and product/engineering. Candidate should have 3-5 years of relevant experience, health tech/telehealth exposure, hands-on billing/credentialing systems experience, and strong payer portal proficiency, with leadership capabilities and strong communication.
Required Qualifications
- 3-5 years of experience in provider credentialing, revenue cycle management, or insurance operations
- Experience building or scaling credentialing or RCM workflows in health tech or telehealth
- Hands-on experience with RCM and billing platforms (Candid or equivalent) and credentialing management tools
- Proficiency with major payer portals (Availity, UnitedHealthcare Link, NaviNet) to audit claim statuses and resolve denials
- Strong knowledge of E&M coding, CPT/ICD-10, and CMS billing guidelines
- Experience leading or managing a small team and developing staff
- Ability to translate complex billing/credentialing issues into operational plans and executive summaries
- Comfort with AI tools and automation in workflows
- Experience owning or supporting prior authorization workflows and payer escalation processes
- Healthcare/telehealth experience and cross-functional collaboration
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