Revenue Accounting Manager

If you are unable to complete this application due to a disability, contact this employer to ask for an accommodation or an alternative application process.

Full Time Plano, TX, US

8 days ago Requisition

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.

The Revenue Accounting Manager is a senior member of the Finance and Accounting team, responsible for leading all aspects of revenue recognition, net revenue reporting, and the operational interface between accounting and revenue cycle management across Legent Health’s multi-facility platform. This role serves as the platform’s subject matter expert for net revenue, contractual allowance methodology, and revenue-related financial reporting.

Reporting to the Assistant Controller with a dotted-line relationship to the SVP of Revenue Cycle Management, this individual is expected to build and lead a small team, establish scalable revenue accounting processes to support acquisitive growth, and deliver institutional-quality reporting to meet private equity sponsor expectations. The initial mandate centers on revenue recognition and RCM collaboration, with scope expanding over time to encompass broader accounting leadership responsibilities.

• Own the end-to-end net revenue reporting process for all facilities, serving as the platform’s subject matter expert for monthly net revenue proofs, contractual allowance validation, and implicit price concession methodology.
• Develop, document, and maintain the company’s revenue recognition policies and procedures in compliance with ASC 606, including the portfolio approach practical expedient for grouping contracts by payer, facility, and specialty.
• Lead the monthly contractual allowance analysis across all payer classes, validating that estimated reimbursement rates align with actual collections and managed care contract terms.
• Oversee implicit price concession estimation using statistical models, historical collection patterns, and propensity-to-pay analysis; lead quarterly hindsight reviews and present findings to senior leadership.
• Manage third-party payer settlement reserves including Medicare APC/OPPS rate adjustments, and commercial managed care true-ups.
• Prepare and present revenue disaggregation disclosures, revenue by case analysis, and payer mix trending to support PE sponsor reporting, board materials, and lender covenant compliance.
• Monitor high-cost implant billing, supply cost pass-through reimbursement, and case-level profitability for all facilities, coordinating with operations on outlier identification.

• Serve as the senior accounting point of contact for the Revenue Cycle Management organization, establishing and leading structured weekly meetings to review AR aging, denial trends, cash application accuracy, and payer performance.
• Design and maintain the data flow architecture between RCM billing systems (HST, CPSI) and the general ledger (Sage Intacct), ensuring completeness and accuracy of revenue-related data transfers.
• Develop standardized reconciliation procedures between the patient accounting system, general ledger, and bank deposits; identify and resolve systemic discrepancies across facilities.
• Partner with the SVP of RCM on charge capture validation, charge master maintenance, payer fee schedule updates, and denial management initiatives that directly impact revenue recognition.
• Establish and monitor revenue cycle KPI dashboards including DSO (target: 35–45 days), clean claim rate (target: >95%), denial rate (target: 96%), and Days in DNFB (target: