Revenue Cycle Consultant

 About Us:

Our purpose is to help clients exceed their financial health goals. Across the reimbursement cycle, our scalable solutions and clinical expertise help solve programmatic needs. Enabling our teams with leading technology allows analytics to guide our solutions and keeps us accountable achieving goals. 

We build long-term careers by investing in YOU. We seek to create an environment that cultivates your professional development and personal growth, as we believe your success is our success.  

JOB SUMMARY:

ESSENTIAL DUTIES AND RESPONSIBILITIES: 
Note: The essential duties and responsibilities below are intended to describe the general duties and responsibilities of this position and are not intended to be an exhaustive statement of duties. This position may perform all or most of the primary duties listed below. Specific tasks, responsibilities or competencies may be documented in the Team Member’s performance objectives as outlined by the Team Member’s immediate Leadership Team Member.

Essential Functions:

Note: The essential duties and primary accountabilities below are intended to describe the general content of and requirements of this position and are not intended to be an exhaustive statement of duties. Incumbents may perform all or most of the primary accountabilities listed below. Specific tasks, responsibilities or competencies may be documented in the incumbent’s performance objectives as outlined by the incumbent’s immediate supervisor or manager.

• Serve as an advisor to hospitals seeking Revenue Cycle insight and guidance on complex regulatory issues under Medicare’s OPPS, IPPS, MPFS, RHC, and CAH reimbursement methodologies.
• Lead monthly web-based meetings with clients to discuss regulatory changes, coding updates, and news pertaining to revenue cycle issues.
• Write and edit articles on topics of interest to a broad community of clients relating to the revenue cycle.
• Prepare carefully researched written responses to client questions submitted in writing via the PARA Data Editor
• Complete revenue cycle assessments by conducting interviews with clinical department leaders to assess appropriate charge capture, identify coding irregularities, and ensure services provided are charged appropriately and reported accurately.
• Serve as subject matter expert in speaking engagements (1 or 2 short trips per year)
• Other duties as assigned

Knowledge, Skills & Abilities:

• Ability to independently research complex regulations and reach accurate conclusions in forming opinions representing the firm.
• Solid understanding of Medicare and Medicaid reimbursement methodology for outpatient hospital, inpatient hospital, ASC, RHC, and professional fee billing
• Excellent verbal and written communications skills; ability to write clear, concise, and accurate opinions underpinned by authoritative references.
• Leadership and coping skills to manage multiple projects concurrently.
• Understanding of billing, coding, compliance and a general understanding of how hospitals work
• Organizational and time management skills
• Knowledge of medical terminology and pronunciation, as well as coding for common procedures
• Intermediate to advanced proficiency in Microsoft Office products, particularly Excel, Word, and PowerPoint
• Associate degree (minimum level of education required) Bachelor’s degree or higher preferred
• Extensive experience and technical writing skills may be considered as a substitute for some higher education.
• Significant experience in revenue cycle operations, including HCPCS/CPT® code use, revenue codes, CCI/MUE edits, Type of Bill utilization, and general patient accounting processes.
• Broad expertise in business office operations for hospitals (acute care, long-term acute care, and critical access), physician clinics (including RHCs, FQHCs, provider-based, and freestanding), and/or skilled nursing facilities is required.

Physical Requirements and Demands:

Note: Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions as described.

Regular eye-hand coordination and manual dexterity is required to operate office equipment. The ability to perform work at a computer terminal for 6-8 hours a day and function in an environment with constant interruptions is required. At times, incumbents are subject to sitting for prolonged periods. Infrequently, incumbent must be able to lift and move material weighing up to 20 lbs. Incumbent may experience elevated levels of stress during periods of increased activity and with work entailing multiple deadlines.

A job description is only intended as a guideline and is only part of the employee’s function. The company has reviewed this job description to ensure that the essential functions and basic duties have been included. It is not intended to be construed as an exhaustive list of all functions, responsibilities, skills, and abilities. Additional functions and requirements may be assigned by supervisors as deemed appropriate.

PHYSICAL DEMANDS:
Note: Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions as described. Regular eye-hand coordination and manual dexterity is required to operate office equipment. The ability to perform work at a computer terminal for 6-8 hours a day and function in an environment with constant interruptions is required. At times, Team Members are subject to sitting for prolonged periods. Infrequently, Team Member must be able to lift and move material weighing up to 20 lbs. Team Member may experience elevated levels of stress during periods of increased activity and with work entailing multiple deadlines.
A job description is only intended as a guideline and is only part of the Team Member’s function. The company has reviewed this job description to ensure that the essential functions and basic duties have been included. It is not intended to be construed as an exhaustive list of all functions, responsibilities, skills and abilities. Additional functions and requirements may be assigned by supervisors as deemed appropriate.