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Pinnacle Healthcare Consulting · 15 hours ago

Revenue Cycle Consultant

United States

Full-time

Onsite

Senior Level

5+ years exp

Pinnacle Healthcare Consulting is an industry leading national healthcare advisory firm headquartered in Denver, Colorado. The Revenue Cycle Consultant role focuses on optimizing provider financial flow by analyzing and improving coding, billing, claims collections, and workflows, while also providing staff training and ensuring compliance with healthcare regulations.

Business DevelopmentHealth CareHospitalInformation Technology

Responsibilities

Conduct in-depth reviews of current workflows (registration, coding, billing, collections, and denials)

Develop action plans and strategies to correct identified issues, improve processes, and leverage technology

Lead or support the implementation of new systems, processes, or training programs

Track key metrics and report on progress

Educate staff on best practices, new policies, and compliance

Ensure adherence to healthcare regulations and payer rules

Provide collaborative client-facing support when necessary to lead work efforts to meet the project plan requirements and deliverable(s) timeline(s)

Collaborate with team resources to participate in drafting reports

Participate in presenting review results to client contacts as qualified

Perform engagement procedures designed to identify and define issues, review and analyze evidence, and document business processes

Prepare working papers to support results of procedures requiring minimal edits from project management lead

Identify, develop and document issues and recommendations using independent judgment concerning areas reviewed within their defined area(s) of expertise and industry skills

Assist in coordinating and communicating the results of consulting and internal audit projects via written reports and oral presentations to clients

Provide input to the project team and status of project to leadership during all project phases

Ensures PERCS’ high expectations for quality in all assigned projects and deliverables under their control

Relays business development opportunities from client communications or when receiving inquiries from internal or external sources to expand project scope or for new work when identified to PERCS’ leadership

Participate with exhibiting and business marketing initiatives alongside leadership team during attended conferences or sales calls to provide technical expertise/ information as qualified and when needed

Qualification

Healthcare revenue cycle managementAAPC credential CIC®AAPC credential COC®AHIMA credential CCSAHIMA credential RHITAHIMA credential RHIACodingBilling ICD-10-CMBilling CPT®Billing HCPCSDenials ManagementHealthcare Compliance knowledgeMicrosoft Office proficiencyCustomer serviceWritten communicationProblem-solving skills

Required

Bachelor's degree or commensurate experience in finance, healthcare administration, or related field will be considered

Knowledge of healthcare revenue cycle management, billing, coding, or finance operations experience in addition to an AAPC credential (CIC® or COC®) or AHIMA credential (CCS, RHIT or RHIA) is required

Minimum five (5) years of revenue cycle management, health care consulting and / or industry experience is required with professional fee claims

Patient Access

Coding and billing (ICD-10-CM, CPT®, HCPCS

Denials Management

Collections

Accounts Receivable

Contract Management

Above average knowledge and understanding of Healthcare Compliance, HIPAA and HITECH requirements

Knowledge of healthcare technology solutions, such as Electronic Medical Record or Patient Financial Services systems

Knowledge of healthcare regulatory requirements

Ability to write business reports or other professional deliverables

Excellent customer service skills, both in-person and telephonically

Strong written communication including report presentation

Competently use Microsoft Office®, including Word, PowerPoint, and Excel

Successfully participate in multiple and rapidly changing projects effectively

Handle confidential information with discretion and adapt to competing demands

Think strategically, solve problems and propose solutions

Work under tight deadlines and manage multiple priorities

Achieve high-performance goals and meet deadlines in a fast-paced environment

Preferred

Experience with Cerner PowerChart, EPIC, Meditech and other EMR systems is preferred

Additional certifications from AAPC or AHIMA, such as CPMA®, CDEI®, CDEO®, CCDS and other relevant Certified Revenue Cycle Specialist (CRCS®) from AAHAM is a bonus