Foresight · 11 hours ago
RCM Technical Implementation Manager
United States
Contract
Remote
Mid, Senior Level
3+ years expForesight is an automation-first revenue cycle and prior authorization platform for telemedicine and specialty clinics. They are seeking an RCM Technical Implementation Manager to refine the architecture for their expansion into end-to-end claims lifecycle automation, working closely with the engineering team to ensure successful client implementations.
Computer Software
Responsibilities
Design clearinghouse integration strategies, eligibility waterfall logic, and ERA/payment reconciliation workflows
Evaluate and recommend partners for eligibility, claims submission, 835 retrieval, and payment reconciliation—deliver a buy vs. build roadmap with realistic timelines
Codify CARC/RARC codes, clearinghouse rejections, and eligibility failures into structured, automation-ready categories with recommended actions
Translate RCM operational realities into technical specs, acceptance criteria, and test plans—you don't write the code, but you ensure what gets built actually works with payers
Own implementation checklists, reconciliation plans, and operational handoff to our RCM operations team
Qualification
Required
3+ years in RCM with hands-on implementation experience—you've migrated clearinghouses, debugged eligibility failures, and built denial workflows
Technical fluency: you understand EDI 835/837, CARC/RARC, 270/271, APIs vs. SFTP, webhooks vs. polling—and can speak to engineers about tradeoffs
Systems thinking: when you see 'Eligibility Not Found,' you immediately consider address mismatches, PBM carve-outs, or enrollment issues
Preferred
Experience at RCM automation vendors (strongly preferred) AND/OR provider-side operations
Vendor wrangling experience with clearinghouses (Stedi, Claim.MD, Availity, Change Healthcare, TriZetto) and/or payment networks (Optum Pay, Zelis, etc)
Company
Foresight
https://have-foresight.com/
2-10 employees
Funding
Current Stage
Early StageCompany data provided by crunchbase