Job Description
DIRECTOR, FRONT-END REVENUE CYCLE MANAGEMENT PSN
Services LLC Plano, TX Job Details Full-time 3 hours ago Benefits Paid time off Qualifications Team leadership Business management Full Job Description About Legent Health At Legent Health , our mission is simple yet profound: "To provide first-class health care that puts YOU first." Our vision reflects our commitment to excellence: "Through robust physician partnerships, become a nationwide leader in compassionate, quality healthcare focused on the patient and available to everyone." Our values, also known as our brand pillars, define how we stay true to our identity in the healthcare industry and the communities we serve. These values are central to everything we do: Respect:
We honor the time and trust of both patients and physicians by delivering organized, efficient services that ensure a seamless healthcare experience. Service:
We are committed to highly personalized care for patients, their families, and the physicians who serve them, driving optimal outcomes for all. Leadership:
We strive to be a trusted leader through innovation, clear communication, and unwavering dedication to excellence across our employees and partners. Joining Legent Health means being part of a team that lives these principles every day, as we build a future focused on compassionate, quality care. About the Role We are 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. We are hiring a Director, Front-End Revenue Cycle Management to own facility-billing front-end operations to end-to-end-from scheduling intake through pre-bill audit gating. This role exists to eliminate preventable denials, protect implant and device reimbursement, and stand up consistent front-end discipline across a fast-growing, multi-site platform. You will lead managers and supervisors across facilities, set the KPIs the platform is measured against, and act as the front-end counterpart to coding, billing, and contracting leadership. POSITION'S ESSENTIAL RESPONSIBILITIES
Essential Duties/Responsibilities:
Patient Access & Scheduling Accuracy 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. Eligibility, Benefits Investigation & Prior Authorization 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. Patient Financial Clearance & Price Transparency 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. Pre-Service Coding Review & Procedure Accuracy 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. Coding Intake & Documentation Readiness 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. Front-End Denial Prevention Analytics 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 
