Job Description

Role Overview:
We are seeking 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 its 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.

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 Skills & Experience

• Knowledge and a working understanding of revenue cycle concepts, business processes, and/or operations within the healthcare industry (commercial or federal).
• Ability to apply principles and practices in revenue cycle management, such as charge capture, coding, billing, reimbursement, denial management, A/R management, and compliance.
• Experience with A/R management, including analysis, process improvement, and standardization.
• Experience with audit readiness processes, including the preparation of audit materials, development of audit responses, and implementation of corrective action plans.
• Experience with compliance management, including policy development, monitoring, and risk assessment.
• Ability to analyze and interpret complex data, processes, and reports related revenue cycle, including A/R data, audit findings, and compliance reports.
• Ability to identify and resolve issues and problems related to revenue cycle, specifically with A/R, audit response, and compliance management.
• Ability to use various software applications and tools to perform revenue cycle management functions, such as:
• Electronic Health Record systems (e.g. Oracle/Cerner MHS GENESIS Cerner Patient Accounting (CPA) RevenueCycle).
• Billing/Claim systems (e.g. Electronic Claims Clearinghouse (SSI), 3M 360 Encompass Institutional & Professional Coding, Claim Scrubber Edits (Alpha ii), Dentrix Billing, Patient Statements/Letters (RevSpring)).
• Data analytics and reporting (e.g. Excel, Power BI, SAS, Tableau, HealtheAnalytics).
• Ability to succeed in a dynamic team environment and produce deliverables in tight timeframes.
• Detail-oriented with a commitment to accuracy and quality.
• Excellent oral, written, and interpersonal skills.
• Ability to collaborate and communicate effectively with team members, clients, business partners, and other various stakeholders.
• Proficiency in Microsoft Office Suite (Excel, Word, PowerPoint).

Formal Education: Bachelor’s degree required, Finance, Business Administration, Healthcare Administration or related field preferred. Masters in Business Administration or related field, ideal.
Years of Professional Experience: 4-6 or more years of consulting or healthcare experience required, preferably in a federal consulting environment.

Desired Skills & Experience

• Experience within the Military Health System (MHS) environment and requisite knowledge of revenue cycle operations.
• Experience with the Oracle/Cerner Electronic Health Record (EHR), Cerner Patient Accounting (CPA) RevenueCycle, HealtheAnalytics, ideally in the MHS environment.
• Knowledge of MHS billing and coding policies and regulations.