DIRECTOR OF REVENUE CYCLE

PSN Services LLC•Plano, TX

1d•Remote

About The Position

Legent Health is seeking a Director of Revenue Cycle Management to provide direct oversight of coding operations and accounts receivable functions across a multi-facility platform of surgical hospitals and ambulatory surgery centers (ASCs). This role is integral to driving coding accuracy, AR performance, denial resolution, and workflow standardization across 11+ facilities specializing in spine, orthopedic, ENT, and pain management. This position is approximately 80% operational and 20% strategic, requiring a leader who understands surgical coding, AR management, and can hold a team accountable to measurable results. The Director reports directly to the AVP of Revenue Cycle Management and serves as a critical bridge between frontline RCM staff and senior leadership.

Requirements

Bachelor’s degree in Healthcare Administration, Business, Finance, or a related field required; relevant certifications (CPC, CCS, RHIT, or equivalent) strongly preferred.
Minimum of 7 years of progressive experience in healthcare revenue cycle operations, with at least 3 years in a supervisory or management role overseeing coding and/or AR teams.
Demonstrated hands-on experience managing both IP/OP coding staff and AR specialist teams—candidates with only high-level supervisory experience will not be considered.
Strong working knowledge of ICD-10-CM/PCS, CPT, HCPCS, and MS-DRG assignment, with specific experience in surgical specialties (spine, orthopedics, ENT, or pain management preferred).
Deep understanding of the claims lifecycle, payer adjudication logic, CARC/RARC denial classification, and AR resolution workflows.
Proficiency in EHR/PM systems used in surgical environments, including CPSI/TruBridge and/or HST Pathways; experience with Waystar or comparable clearinghouse platforms required.
Data-driven mindset with experience building or utilizing RCM reporting dashboards and KPI frameworks to manage team performance and drive accountability.
Skilled at identifying process gaps and translating findings into actionable SOPs and training materials for frontline staff.
Exceptional organizational skills with the ability to manage competing priorities across multiple facilities and functional areas simultaneously.
Strong interpersonal and communication skills with the ability to engage effectively with frontline staff, peer leaders, and senior stakeholders.

Nice To Haves

Relevant certifications (CPC, CCS, RHIT, or equivalent) strongly preferred.

Responsibilities

Provide direct oversight of inpatient and outpatient coding teams, ensuring accuracy and timeliness across ICD-10-CM/PCS, CPT, and HCPCS coding for surgical specialties including spine, orthopedics, ENT, and pain management.
Drive MS-DRG optimization through appropriate principal diagnosis selection, complication/comorbidity (CC/MCC) capture, and procedure coding accuracy for surgical inpatient encounters.
Monitor and maintain coding quality metrics including coding accuracy rates, coder productivity benchmarks, charge lag, and unbilled A/R related to coding holds.
Conduct or coordinate regular audits of coded charts, identify patterns of error or missed revenue opportunity, and implement coder education and corrective action plans.
Oversee charge capture integrity across CPSI/TruBridge and HST Pathways environments, ensuring CDM alignment and appropriate charge reconciliation post-encounter.
Collaborate with clinical operations and compliance teams to ensure coding reflects documented clinical intent and meets payer and regulatory requirements.
Lead AR specialist teams across payer categories including commercial, Medicare, Medicaid, workers’ compensation, and managed care, maintaining accountability for aging buckets, follow-up timelines, and collection performance.
Establish and enforce AR work queue structures and prioritization protocols to ensure timely payer follow-up and appropriate escalation of aged or high-dollar claims.
Monitor AR aging reports and collection trends at the facility and payer level; identify root causes of AR aging and implement corrective workflows to reduce days in A/R.
Partner with billing and payment posting teams to ensure clean claim submission, timely ERA/EOB application, and accurate account resolution across Waystar and facility PM systems.
Own the denial management function end-to-end—from root cause identification using CARC/RARC data to appeal submission, payer escalation, and process correction.
Build and maintain denial reporting frameworks that categorize denials by type, payer, facility, and root cause, enabling targeted operational improvement.
Work directly alongside coders and AR specialists to resolve complex denial scenarios including medical necessity, authorization, coding-based, and timely filing denials.
Identify systemic denial trends and develop or update SOPs to prevent recurrence at the point of access, coding, or billing.
Lead and manage RCM-specific projects from initiation through completion, including system implementations, facility onboardings, payer enrollment initiatives, and workflow redesign efforts across the MSO’s surgical platform.
Develop and maintain project plans with clearly defined milestones, owners, timelines, and success metrics; communicate status updates and risk flags to the AVP on a regular cadence.
Manage transitions of RCM functions — including new facility integrations, vendor changes, and in-house migrations — with minimal disruption to billing continuity and cash flow.
Identify operational dependencies and sequencing risks across concurrent projects; proactively escalate conflicts or resource constraints before they impact go-live timelines.
Build and maintain project documentation including SOPs, workflow diagrams, training materials, and post-implementation review summaries to support knowledge retention and staff onboarding.
Support change management efforts by communicating process changes clearly to coding and AR teams, ensuring adoption is tracked and issues are resolved quickly.
Develop, document, and enforce standard operating procedures for coding workflows, AR follow-up, and denial resolution tailored to outpatient surgical environments.
Define and track KPIs including clean claim rate, first-pass resolution rate, denial rate by payer/type, coder accuracy, AR days, and cash collection performance.
Identify workflow inefficiencies and drive continuous improvement initiatives that reduce rework, improve throughput, and protect net revenue.
Provide regular performance reporting and operational updates to the AVP highlighting trends, risk areas, and action plans with measurable outcomes.
Directly supervise and develop coding and AR team leads and specialists, building a culture of accountability, transparency, and continuous improvement.
Conduct regular 1:1s, team huddles, and performance reviews; address performance gaps proactively with clear expectations and documented action plans.
Collaborate with the AVP on automation initiatives, technology optimization (CPSI/TruBridge, HST Pathways, Waystar), and integration of new facilities into the MSO operating model.
Serve as an operational subject matter expert supporting cross-functional projects with IT, compliance, finance, and clinical leadership.
Ensure adherence to payer guidelines, federal and state regulations, and contractual billing requirements across all facilities and service lines.