Medical Billing Manager, RCM Operations (Contract-to-Hire, NYC or Remote) $60/h

Remote Full-time
About Foresight

Foresight is an automation-first revenue cycle and prior authorization platform for telemedicine and specialty clinics. We automate the full claims, eligibility, ePA, and payment reconciliation lifecycle. VC-backed, early-stage, growing and improving weekly.
The Role

You'll own the day-to-day billing queues across our live clients, running eligibility, working denials, posting payments, chasing rejections, and catching the things our automation doesn't yet cover. You'll handle all billing while we start working with clients, and exceptions when automation is deployed. You will be able to hire support billing staff when volume requires it.

This isn't a checklist-biller seat. You'll also drive the weekly client touchpoints, flag the patterns worth automating to engineering, and grow into leading other billers as we scale the client base.

What you'll do
• Run daily eligibility; work rejections; post ERAs and paper EOBs across eClinicalWorks and Healthie primarily
• Log into payer portals (TriZetto, Medicaid ePrep, ECHO, commercial plans) and diagnose issues directly, calling payers when needed
• Work denials and appeals end-to-end: find the root cause (coding, credentialing, eligibility, COB), fix, resubmit, and tell us which patterns deserve automation
• Reconcile payments: match ERAs to deposits, track underpayments and take-backs, chase unposted remits
• Show up on the weekly client call, send the recap, and be the face of RCM Ops to each client you cover
• Feed engineering real-world edge cases: when you hit the same pothole twice, we want to hear it before the third time
• Keep the claims tracker honest: timely filing discipline, AR aging, nothing falls through

What you bring
• 4-6 years provider or vendor-side RCM experience
• Full-lifecycle comfort: eligibility → prior auth awareness → claims → denials → payment posting → AR
• Specialty experience in at least one of: behavioral health / addiction medicine, HIV or Ryan White, or telehealth
• Fluent in eClinicalWorks or a comparable modern EHR; quick pickup on new systems
• Proactive communicator: acknowledges issues immediately, gives timelines, closes the loop
• Methodical.
• Opinionated enough to push what you think are the right priorities to focus on.

Why this role
• Your feedback becomes the product. We're actively building the automation that would otherwise be your workarounds. You're at the source.
• Real path to lead
. Start hands-on; grow into leading the billers we hire as clients scale. Conversion to full-time with equity is the intended trajectory.
• $60/hr
while as a contractor.
• Fast, on-it team, direct work with experienced founders and engineering.

Logistics
• Contract-to-hire
• Remote or NY, US-based
• ~10-20 hrs/week to start (flexible), scaling with client load

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