Director, Front-End Revenue Cycle Management (RCM)

Location: Texas and Florida (Multi-Site Operations)
Employment Type: Full-Time
Industry: Healthcare Revenue Cycle Management

Position Summary

We are seeking an experienced Director of Front-End Revenue Cycle Management (RCM) to lead patient access, benefits verification, and authorization operations across a growing multi-site healthcare organization. This leader will oversee a team of approximately 10 revenue cycle professionals and drive operational excellence through process automation, technology adoption, and performance management.

The ideal candidate brings a strong background in facility-based healthcare revenue cycle operations, including eligibility verification, coverage discovery, prior authorizations, and revenue integrity. This role requires expertise in automation technologies, AI-driven solutions, and EDI transactions to improve front-end revenue cycle performance, reduce denials, and optimize the patient financial experience.

Key Responsibilities

• Lead and develop a front-end RCM team responsible for insurance verification, benefits validation, coverage discovery, and authorization management.
• Drive automation initiatives that improve efficiency, accuracy, and scalability across patient access functions.
• Leverage AI-enabled tools and EDI transactions (270/271) to streamline eligibility verification and payer communication workflows.
• Establish and monitor key performance indicators (KPIs) related to registration accuracy, eligibility validation, authorization compliance, and denial prevention.
• Partner with operations, clinical, and revenue cycle stakeholders to improve reimbursement outcomes and reduce revenue leakage.
• Standardize front-end workflows across multiple facilities and geographic locations.
• Support the integration of newly acquired facilities by implementing consistent revenue cycle processes, technology platforms, and payer management strategies.
• Ensure compliance with payer guidelines, authorization requirements, Local Coverage Determinations (LCDs), and National Coverage Determinations (NCDs).
• Analyze operational data and develop action plans to improve financial performance and patient access outcomes.

Required Qualifications

• Bachelor's degree in Healthcare Administration, Business Administration, Finance, or a related field; equivalent experience will be considered.
• Minimum 3 years of facility-based revenue cycle experience within:
  • Surgical Hospitals
  • Hospital Outpatient Departments (HOPDs)
  • Ambulatory Surgery Centers (ASCs)
• Demonstrated leadership experience managing teams of approximately 10 or more employees across multiple locations.
• Hands-on experience with:
  • Patient benefits validation
  • Coverage discovery
  • Revenue cycle automation technologies
  • AI-enabled workflow solutions
  • EDI transactions, including 270/271 eligibility verification processes
• Strong knowledge of authorization requirements, payer policies, and front-end revenue cycle best practices.
• Experience supporting high-cost procedural specialties such as:
  • Spine
  • Orthopedics
  • Ear, Nose & Throat (ENT)
  • Pain Management
• Deep understanding of implant and medical device reimbursement considerations.

Preferred Qualifications

• Experience working within a private equity-backed healthcare organization.
• Proven success in scaling revenue cycle operations across multi-site healthcare platforms.
• Experience leading change management initiatives, including system migrations and operational standardization efforts.
• Strong analytical skills with the ability to translate operational performance into measurable financial outcomes.

Key Performance Indicators (KPIs)

Success in this role will be measured through:

• Registration accuracy rates
• Pre-service eligibility verification completion rates
• Clean claim first-pass acceptance rates
• Authorization-related denial rates
• Eligibility-related denial rates
• Point-of-service (POS) collection performance
• Operational efficiency and automation adoption metrics

Skills

• Revenue Cycle Management (RCM)
• Patient Access Operations
• Insurance Verification
• Prior Authorization Management
• EDI Transactions (270/271)
• Artificial Intelligence (AI) Applications
• Healthcare Automation
• Denial Prevention
• Multi-Site Operations Management
• Process Improvement
• Healthcare Financial Operations
• Leadership and Team Development

This role offers an opportunity to lead strategic front-end revenue cycle initiatives, implement innovative technology solutions, and drive measurable improvements in operational and financial performance across a growing healthcare platform.

Apply now