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Revenue Cycle Operations Consultant – Back End
Job Description:
- Perform audits, consolidations, and standardizations of Charge Data Masters (CDM/CGT) and Revenue Integrity workflows
- Improve charge capture accuracy through workflow assessments, coordinating coding reviews, process improvements, and report generation
- Work closely with Information Services to complete and test charge-related build by having a clear understanding of the charging workflows and triggers built within the EMR
- Work collaboratively to assist in the development and implementation of process enhancements or initiatives that enhance charge capture accuracy and reimbursement
- Leverage functionality of revenue cycle Epic application to increase clean claim rate, reduce denial rates and increase cash collections, through implementation of claim rules and edits and cascade information to impacted stakeholders and to Revenue Cycle Leadership
- Use data and reports to perform root cause analysis to identify areas of opportunities to organizational revenue integrity
- Manage complex projects related to existing and new revenue initiatives to increase reimbursement and provide support for projects.
Requirements:
- Bachelor’s degree required
- Epic Certifications (Resolute HB, SBO, Charge Capture, CDM) preferred
- 7+ years of experience in healthcare operations related to revenue integrity, coding, finance, revenue cycle management, patient accounting and/or physician billing
- 2+ years of experience working in an Epic environment
- 2+ years of healthcare consulting experience
- Proven success leading large-scale Revenue Integrity Strategic development and implementation
- Full understanding of charging capture and charge reconciliation processes, including the electronic health record charge links to the CDM and charge capture processes to ensure compliance with government and third-party payer requirements
- Authorized to work in the US.
Benefits:
- Annual discretionary bonus
- Additional benefits and perks may also be available, depending on the position and employment terms.
