DIRECTOR, FRONT-END REVENUE CYCLE MANAGEMENT

PSN Services LLC•Plano, TX

12h•Remote

About The Position

Legent Health is a private-equity backed surgical hospital and ASC platform operating 10+ facilities across Texas and Florida, with a service-line concentration in spine, orthopedics, ENT, and pain management. They are hiring a Director, Front-End Revenue Cycle Management to own facility-billing front-end operations from scheduling intake through pre-bill audit gating. This role is crucial for eliminating preventable denials, protecting implant and device reimbursement, and establishing consistent front-end discipline across a fast-growing, multi-site platform. The Director will lead managers and supervisors across facilities, set platform KPIs, and act as the front-end counterpart to coding, billing, and contracting leadership.

Requirements

Bachelor's degree in healthcare administration, finance, business, or related field- or equivalent combination of experience and credentials.
8+ years of progressive healthcare revenue cycle experience, with at least 4 years in a front-end leadership role (Manager or above).
Demonstrated experience leading front-end operations across multiple facilities or sites simultaneously.
Advanced Excel skills including pivot tables, formulas, and data analysis.
Experience with clearinghouse systems and electronic claim processing.
Familiarity with prior authorization platforms and payer portals.
3+ years of facility (UB-04) RCM experience-at Surgical hospitals or ASCs.

Nice To Haves

Active credential in one or more of the following: HFMA: Certified Revenue Cycle Representative (CRCR) or Certified Healthcare Financial Professional (CHFP). NAHAM: Certified Healthcare Access Manager (CHAM) or Certified Healthcare Access Associate (CHAA). AAHAM: Certified Revenue Cycle Specialist (CRCS), Certified Revenue Cycle Professional (CRCP), or Certified Revenue Cycle Executive (CRCE).
Prior experience at a private-equity backed multi-facility platform, including standing up centralized front-end functions and operating to EBITDA-linked KPIs.
Experience integrating acquired facilities onto a common front-end platform (system conversions, CDM consolidation, payer grid harmonization.)
Familiarity with implant-pass-through billing, NOPAIN Act non-opioid device payment rules, and carve out contract language for ortho, spine, and pain devices.
Knowledge of DRG optimization and high-cost outlier case management.
Service-line depth in at least two of: spine, orthopedics, ENT, pain management-including implant/device billing, authorization patterns, and LCD/NCD navigation.

Responsibilities

Own pre-registration & accurate demographic capture across HST Pathways (ASCs) and CPSI/TruBridge (Surgical Hospitals); eliminate cross-facility identity mismatches that drive downstream denials.
Standardize pre-service touchpoint cadence across all facilities so registration accuracy holds at or above 98% system-wide.
Direct real-time eligibility and full benefits investigation workflows in Waystar/TruBridge RCM Clearinghouse platforms, including line-item benefits verification for high-cost implants and devices (spine hardware, total joint components, neurostimulators, etc.) with documented remaining deductible, OOP max, implant carve-out language captured before the date of service.
Establish and enforce a benefits verification completion threshold of 72 hours prior to the date of service for all scheduled cases, with same-day escalation protocols for late-scheduled or add-on procedures to ensure no case reaches the OR without confirmed coverage and auth on file.
Enforce a platform-wide standard requiring active authorization on file for all scheduled cases no later than 72 hours prior to the date of service, with escalation triggers for any case approaching the threshold without confirmed auth and a hold protocol that prevents unverified cases from proceeding to the OR.
Lead prior authorization for high-dollar procedures (lumbar/cervical fusions, total joings, Spinal Cord Stimulator trials and permanent implants, sinus and ENT implantable devices); maintain payer-specific authorization grids, LCD/NCD alignment, and a peer-to-peer escalation pathway with physicians.
Track authorization approval rates, turnaround times, and peer-to-peer outcomes by payer and procedure category; use approval rate trends to identify payers tightening clinical criteria and proactively update auth submission templates and clinical packages before denial rates climb.
Own Good Faith Estimate production and pre-service delivery to all patients in compliance with No Surprises Act requirements, including convening-facility coordination and dispute resolution workflows.
Optimize point-of-service collection standards (estimate generation, copay, deductible, and implant-share collection); target 90%+POS collection of patient responsibility on scheduled cases.
Lead pre-service coding reviews on high-revenue procedures to ensure the procedure, scheduled on the posting sheet is accurately reflected in the surgical packet- correct CPT/HCPCS codes, appropriate modifiers, and supporting documentation in place before the date of service.
Partner with scheduling, surgeons' offices, and HIM/coding to resolve procedure mismatches, missing implant or device line items, and documentation gaps upstream of the OR, preventing the revenue loss and rework that results from miscoded or incomplete surgical packets reaching the billing team.
Build pre-bill audit gates that block claims missing op note completeness, implant invoice attachment, or required modifiers (PN for non-excepted off-campus HOPD services under Section 603 of the Bipartisan Budget Act of 2015; 50 bilateral; 59/XS for distinct procedural service; PT and others as applicable.)
Partner with HIM/coding leadership to resolve documentation gaps before claim submission rather than as denials, and feed structural fixes back into surgeon office and pre-op workflows.
Build root-cause reporting on registration, eligibility, and authorization-driven denials by payer, facility, and service line.
Hit and sustain platform front-end KPI targets: registration accuracy ≥ 98%, eligibility verified pre-service ≥95%, clean claim rate ≥98% first-pass authorization-driven denial rate < 2%, and eligibility-driven denial rate <1%.
Set clear goals and expectations; provide regular coaching, feedback, and performance reviews.
Develop talent through mentoring, training, and career development initiatives.
Promote a collaborative and engaging work environment that aligns with company values.
Manage conflict and make timely decisions to maintain team focus and performance.
Conduct regular one-on-one meetings, performance reviews, and development conversations.
Approve timecards, schedules, time-off requests, and other administrative HR functions.
Ensure compliance with company policies, labor laws, and safety regulations.