Healthcare Director, Front-End Clearance

Director, Front‑End Clearance - Revenue Cycle Team (Fully remote; minimal travel). Lead and oversee all front‑end clearance operations, including referrals, authorizations, insurance verification, eligibility and coordination of benefits across U.S. and offshore teams. Drive process improvements, ensure compliance and maximize clean claim rates. Responsibilities Provide leadership and direction for all front‑end revenue cycle functions, including referrals, authorizations, insurance verification, eligibility and coordination of benefits. Lead and coordinate efforts between onshore and offshore teams, ensuring service quality, productivity, and adherence to SLAs. Ensure accuracy, timeliness and compliance across all front‑end processes to minimize denials and maximize clean claim rate. Monitor daily operations, identify bottlenecks, and implement corrective action plans as needed. Establish standardized workflows, playbooks, and escalation paths to drive consistency and efficiency across all functions. Partner with senior leadership to design and implement initiatives that optimize front‑end operations and improve overall revenue cycle outcomes. Leverage automation, technology, and analytics to streamline processes and reduce manual errors. Drive continuous improvement projects focused on improving patient access, reducing turnaround times, and increasing DAR through clean claims. Implement training and education programs for staff to maintain high levels of accuracy and compliance. Establish, monitor, and report on KPIs, including eligibility verification accuracy rate; authorization turnaround time; referral processing; coordination of benefits accuracy; clean claim rate; denial prevention and reduction rates. Proactively identify areas of compliance risk and develop mitigation strategies. Perform other duties and responsibilities as required, assigned, or requested. Qualifications Bachelor’s degree in business or related field and/or equivalent work experience. SHAM and/or CRCR preferred. Lean Six Sigma Green Belt or PMP highly desired. 10+ years of progressive experience in Revenue Cycle Management. 5 years in a senior leadership role overseeing front‑end/pre‑billing operations. Demonstrated success managing both onshore and offshore teams, driving accountability and quality across geographies. Strong knowledge of payer authorization policies, insurance eligibility requirements, and compliance standards. Proven track record of improving clean claim rates, reducing denials, and optimizing front‑end workflows. Exceptional leadership, communication, and change management skills. Strong analytical mindset with ability to leverage data for decision‑making and process improvement. Experience in Nephrology RCM strongly preferred. Strong project program management skills. Prior experience with Athena strongly preferred. Equal Employment Opportunity The Company is committed to the principles of equal employment. We are committed to complying with all federal, state, and local laws providing equal employment opportunities, and all other employment laws and regulations. It is our intent to maintain a work environment which is free of harassment, discrimination, or retaliation because of age, race, color, national origin, ancestry, religion, sex, pregnancy (including childbirth, lactation and related medical conditions), physical or mental disability, genetic information (including testing and characteristics), veteran status, uniformed servicemember status, or any other status protected by federal, state, or local laws. The company is dedicated to the fulfillment of this policy in regard to all aspects of employment, including but not limited to recruiting, hiring, placement, transfer, training, promotion, rates of pay, and other compensation, termination, and all other terms, conditions, and privileges of employment. #J-18808-Ljbffr PH_LOGO_LARGE