Credentialing & Revenue Cycle Manager

Healthcare is broken at the first step: patients cant find the right care understand what it costs or access the medications they need. Mochi Health is fixing this.

Were building an AI-driven marketplace that makes healthcare discoverableconnecting patients to the right providers transparent pharmacy pricing and affordable medications. Over the past few years weve grown rapidly by combining clinical expertise with technology that actually works for real people not just hospital systems.

Our platform does what legacy healthcare cant: it gives patients transparent pricing before they pay personalized medication management that follows them across providers and long-term access to their own medical records. Were proving that healthcare can be more affordable more human and far more intuitive than what exists today.

Join a team thats rebuilding healthcare from the patient up. At Mochi Health youll work alongside people who value bold thinking inclusive collaboration and getting meaningful work into the world. If you want to do the most impactful work of your career this is where to do it.

Mochi Health is entering a new phase of clinical growth including the expansion of insurance-reimbursed services for our patient population. As Manager of Credentialing & Revenue Cycle you will own provider credentialing and payer enrollment across our multi-state provider network and build the billing infrastructure needed to support reimbursement at scale.

This is a builder role. You are not inheriting a mature system. You will design the workflows select the tooling and stand up the processes that underpin how Mochi earns revenue from clinical care. You will report directly to the Head of Operations and work closely with clinical ops insurance ops and our product and engineering teams.

Credentialing & Payer Enrollment

• Manage end-to-end provider credentialing and payer enrollment across multiple states and medical entities
• Maintain credentialing timelines and payer enrollment status across the provider network
• Coordinate with medical directors and credentialing bodies on initial and re-credentialing cycles
• Support payer contracting and in-network participation strategy as we expand care programs

Revenue Cycle Management

• Own the operational buildout of E&M billing for the Wellness Plus program from claim submission through payment reconciliation
• Partner with coding clinical and finance teams to ensure accurate CPT and ICD-10 documentation and submission
• Monitor denial trends conduct root cause analysis and implement corrective workflows
• Build and maintain reporting on key RCM metrics: denial rate days in AR clean claim rate net collection rate

AI and Automation

• Actively integrate AI-assisted tools into credentialing and RCM workflows including prior authorization support coding suggestion tools and payer portal automation
• Identify high-volume manual processes that can be reduced through automation and partner with product and engineering to scope and ship improvements
• Evaluate new health tech tooling as the landscape evolves and bring informed recommendations to the team

Team and Cross-Functional Leadership

• Manage and develop a small team supporting credentialing and RCM operations
• Partner with insurance ops pharmacy ops and clinical ops on overlapping workflows
• Serve as the internal subject matter expert on payer policies E&M billing requirements and credentialing compliance

• 3-5 years of experience in provider credentialing revenue cycle management or insurance operations
• Meaningful experience in health tech or telehealth including building or scaling workflows in a fast-moving environment
• Has built or rebuilt a credentialing or RCM function not just inherited one
• Hands-on experience with RCM and billing platforms (Candid or equivalent) credentialing management tools and practice management systems
• Expert-level proficiency navigating major commercial payer portals (Availity UnitedHealthcare Link NaviNet) to audit claim statuses track down stuck remittances and resolve complex multi-network denials outside automated billing workflows
• Solid working knowledge of E&M coding CPT/ICD-10 and CMS billing and telehealth billing guidelines
• Comfortable using and evaluating AI tools and automation platforms; has incorporated these into actual workflows
• Has managed a small team and can develop people while staying hands-on
• Strong communicator who can translate complex billing or credentialing issues into clear operational plans and executive summaries

• Experience with multi-entity or multi-state provider networks
• Background in direct primary care or GLP-1/metabolic telehealth
• CPMSM CPCS or CRCR certification
• Experience owning or supporting prior authorization workflows and payer escalation processes

Life at Mochi

At Mochi we believe your best work happens when you feel your bestso weve designed an environment that fuels your creativity supports your growth and makes every day exciting.

ALL MEALS CATERED five days a week breakfast lunch and dinner professionally catered. On-site Barista with unlimited espresso and matcha

Transports on us Transportation benefits to make commuting painless

Profitable & Explosive Growth Our growth is like trying to drink from a firehose while riding a rocket as we commit to decisions that ensure long-term success stability and the well-being of our team and customersall without the constraints of VC funding.

High-Impact Work Be part of shaping the future of digital healthcare during an exciting period of growth and innovation.

World-Class Team Join a team of ex-Tesla Citadel SpaceX Harvard Princeton Yale Dartmouth IIT across engineering product clinical operations and beyondeach bringing excellence and empathy to the table.

All the standard bits 401(k) match unlimited PTO fully covered life insurance super primo medical dental and vision for our injury prone team.

Competitive Compensation We offer a top-of-market salary and a generous equity packagebecause you deserve to share in the upside you help create.

Prime Location Our vibrant downtown San Francisco HQ is just steps from public transit great coffee shops and everything the city has to offer.

The base salary for this full-time position ranges from $130000 to $160000 in addition to equity and benefits. The salary range listed in each job posting represents the minimum and maximum targets for new hire salaries across all locations. Actual compensation within this range is determined by various factors such as job-related skills experience relevant education or training and location.

#LI-Onsite

Mochi Health is an in-person company based in San Francisco CA. Our team works together in person five days a week to foster collaboration innovation and strong connections. We believe that face-to-face interaction builds a culture of excellence and allows us to deliver the best outcomes for the patients and providers we serve.

Mochi Health is an Equal Opportunity Employer. We make all employment decisions based solely on merit. We provide equal employment opportunities to all applicants and employees without discrimination on the basis of race religion color national origin gender (including pregnancy childbirth or related medical conditions) sexual orientation gender identity gender expression age status as a protected veteran disability status or any other applicable legally protected characteristic. We prohibit any form of discrimination or harassment. This policy applies to all terms and conditions of employment including hiring.

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Mochi Health complies with the Americans with Disabilities Act (ADA) as amended by the ADA Amendments Act and all applicable state or local laws. We will reasonably accommodate qualified individuals with a disability during the application process and throughout employment as required by law.

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