Revenue Cycle Consultant (Staff Consultant I)

Position Summary

A highly motivated and detail-oriented Revenue Cycle Consultant (Staff I) to join our team. As a Revenue Cycle Consultant, you will provide professional consulting services to assist our Defense Health Agency (DHA) client in managing their operational and revenue cycle operations. This individual will play a critical role in supporting our clients with their revenue cycle management needs, focusing primarily on accounts receivable (A/R) management, audit readiness and response, compliance management, and project management support.

Key Responsibilities

• Accounts Receivable (A/R) Management Support:
• Assist in the analysis and reconciliation of A/R data to identify trends, patterns,and potential areas for improvement.
• Support the development and implementation of A/R management strategies and best practices.
• Participate in process discussions to highlight areas for improvement and standardization.
• Contribute to the development of reports and presentations summarizing A/R performance.
• Participate in client meets to discuss A/R findings and recommendations.
• Audit Readiness and Response:
• Assist with the preparation and organization of materials for internal and external audits related to revenue cycle.
• Support the development of clear, concise, and well-supported audit responses to address findings.
• Ensure documentation is accurate, complete, and organized in accordance with regulatory guidelines.
• Assist with the development and implementation of corrective action plans to address audit findings.
• Contribute to the development of audit remediation strategies and track implementation progress.
• Compliance Management:
• Support the development and implementation of compliance policies and procedures related to revenue cycle activities and internal controls.
• Assist in monitoring compliance with relevant regulations (e.g. Federal, Industry, Financial Management Regulation, DHA Guidance).
• Participate in compliance audits and reviews to identify areas of risk and potential non-compliance.
• Support the development of training materials and presentations related to compliance.
• Assist with tracking and monitoring of compliance issues and resolutions.

Project Management Support

• Assist in the planning, execution, and monitoring of projects.
• Contribute to the development of project plans, timelines, and deliverables.
• Track project progress and identify potential risks and issues.
• Participate in internal and external team meetings and knowledge sharing activities.
• Facilitate communications among project team members, business partners, and client stakeholders.
• Prepare project status reports and presentations.
• Conduct research and analysis of relevant industry trends, regulations, and best practices.
• Maintain a strong understanding of federal healthcare regulations and policies.

Required Qualifications

• 2 to 4 years of experience in healthcare revenue cycle operations, healthcarefinance, or healthcare consulting.
• General understanding of the end-to-end revenue cycle, including registration, charge capture, coding, billing, payment posting, denials, and collections.
• Experience pulling and working with healthcare data to find trends or errors and summarize results.
• Experience working in an electronic health record or revenue cycle system.
• Ability to write clear documentation, such as process notes, SOPs, or reports.
• Proficiency in Microsoft Excel (pivot tables, lookups, and basic formulas), plus working proficiency in Word and PowerPoint.
• Strong attention to detail and the ability to manage multiple tasks and deadlines.
• Clear written and verbal communication skills.
• Willingness to learn new systems, federal regulations, and client processes.
• Bachelor's degree in healthcare administration, business, finance, accounting, or a related field.
• Ability to obtain and maintain a Public Trust.

Desired Skills

• Proficiency with electronic health record and revenue cycle software and systems, such as:

• o Electronic Health Record systems (Oracle/Cerner MHS GENESIS Patient Accounting Module CPAM)
• o Billing, coding and claim solutions (Electronic Claims Clearinghouse SSI; 3M 360 Encompass Institutional & Professional Coding; Claim-Scrubber Edits Alpha II; Dentrix Billing; Patient Statements/Letters RevSpring)
• o Data analytics tools (Excel, Power BI, SAS, Tableau, Qlik Sense) / repositories (Excel, MHS GENESIS, ABACUS, M2, MDR, EAS IV, Health Data Intelligence/HealtheAnalytics)

• Hands-on experience in back-end functions, such as billing, claims follow-up, denials management, payment posting, or collections.
• Experience supporting compliance reviews, audit readiness, or corrective action plans.
• Experience developing training materials or delivering training.
• Experience supporting the MHS, DHA, Veterans Health Administration (VHA), or other federal healthcare organizations.
• Certified Revenue Cycle Representative (CRCR) or a similar revenue cycle certification.