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Remote Reimbursement Manager

Remote: 
Full Remote
Contract: 
Full time
Work from: 
California (USA)

Offer summary

Qualifications:

Bachelor’s degree in Business, Finance, Accounting, Healthcare Administration, or related field., 5+ years of experience in healthcare revenue cycle management, including claims processing, coding, and payment posting., Proven experience leading teams and managing RCM systems in a multi-entity environment., Strong technical understanding of SFTP, 837/835 EDI, and charge capture systems..

Key responsibilities:

  • Manage and optimize processes for the full revenue cycle from eligibility and coding to claim submission and denial analysis.
  • Lead and mentor a cross-functional team of eligibility administrators, medical coders, payment posters, and denial managers.
  • Analyze claims and denial data to identify coding and billing improvement opportunities.
  • Collaborate with Clinical, Product/Engineering, and Operations teams to align billing strategy with service delivery.

Enara Health logo
Enara Health Scaleup https://www.enarahealth.com/
51 - 200 Employees
See all jobs

Job description

Enara is a world renowned obesity and medical weight loss start-up, based in Silicon Valley, pioneering the use of data, digital, and clinical treatments to provide personalized plans with measurable results. Enara was founded by people from Stanford, UCSF, Kaiser, ClassPass & Evernote. Our mission is to develop the first ever platform to scale obesity treatment. Our platform allows for the latest breakthroughs in nutrition, exercise, and obesity science to be optimized and delivered in a series of personalized and programmable experiences. We are looking for similarly talented, passionate and motivated individuals to help us continue to build an exceptional company and deliver effective solutions to improve health and longevity by delivering high-quality medical weight management care.

Team Values
1. Empathy (First) - Every patient’s journey is unique, and we approach each with compassion and understanding, always treating patients with dignity.
2. Empowerment (Through Partnership) - Patients are partners in their health journey. We strive to educate, motivate, and support them at every step.
3. Respect for Diversity - We embrace and honor the unique backgrounds, cultures, and identities of every individual, fostering an environment of inclusion and understanding.
4. Innovation (for Change) - We’re committed to challenging the status quo in healthcare, advancing technology and protocols to create sustainable health outcomes.
5. Service - Heart of Service - With humility and purpose, we dedicate ourselves to serving others, putting compassion and commitment at the heart of everything we do.

Key Roles & Responsibilities:
  • We are seeking a Revenue Cycle Manager who will lead and scale our insurance revenue operations, overseeing coders, payment posters, and denial managers. The ideal candidate brings strong analytical, operational, and technical expertise — with proven experience managing multi-entity RCM infrastructures and automating claim submission and patient billing processes.

  • You will be responsible for managing and optimizing our processes for full revenue cycle — from eligibility and coding to claim submission and denial analysis.

  • Lead and mentor a cross-functional team of eligibility administrators, medical coders, payment posters, and denial managers (offshore and outsourced)
  • Set and monitor team KPIs, workloads, and performance dashboards
  • Develop structured daily/weekly workflows and escalation protocols
  • Set up and manage multi-TIN (Tax Identification Number) billing infrastructure, including payer portal access across multiple entities
  • Establish and maintain SFT/SFTP systems for secure charge capture and electronic remittance processing (837/835 files)
  • Build and maintain custom dashboards for denial analysis, reimbursement trends, and operational performance metrics
  • Analyze claims and denial data to identify coding and billing improvement opportunities
  • Create worklists and data-driven assignments for coders, posters, and denial specialists
  • Develop policies and tools to reduce days in A/R, increase first-pass resolution rates, and ensure payer compliance
  • Collaborate with Clinical, Product/Engineering, and Operations teams to align billing strategy with service delivery
  • Support payer contracting, MIPS reporting, and special billing initiatives such as Remote Patient Monitoring (RPM)
  • Maintain up-to-date knowledge of Medicare and commercial payer regulations, CPT/ICD coding updates, and reimbursement policy changes

    • Qualifications:
  • Bachelor’s degree in Business, Finance, Accounting, Healthcare Administration, or related field
  • 5+ years of experience in healthcare revenue cycle management, including claims processing, coding, and payment posting
  • Proven experience leading teams and managing RCM systems in a multi-entity environment
  • Strong technical understanding of SFTP, 837/835 EDI, and charge capture systems ( ability to set those up using Agentic tools is huge plus). 
  • Expertise in denial management, coding rules, and claims workflow optimization
  • Proficient in analyzing large datasets and creating dashboards (BigQ, Looker)
  • Deep knowledge of CPT, HCPCS, ICD-10, and payer billing requirements
  • Familiarity with Medicare and commercial insurance reimbursement practices
  • Exceptional organizational, analytical, and communication skills
  • Familiarity with Apero Health billing platform is plus.

  • Bonus Qualifications:1+ years of experience in Merit-Based Incentive Payment System (MIPS) reporting.

    • Required profile

    Experience

    Spoken language(s):
    English
    Check out the description to know which languages are mandatory.

    Hard Skills

    Coding TheoryRevenue ManagementClaims And Litigation ManagementICD 503Analytical DashboardAnalyticsCppunitOnline Charging SystemsReward Management

    Other Skills

    • Analytical Thinking
    • Communication
    Are you interested?

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