Community Healthcare Revenue Cycle Management, Independent Contractor

This is a fully remote position, open to applicants in United States.

📋 Description

• Prepare Medicare 519 wrap rate applications by collecting and validating data, completing necessary analyses and documentation, and managing the submission process.

• Provide guidance to FQHC clients regarding Medicare reimbursement, PPS/wrap payments, billing requirements, and associated revenue cycle factors.

• Evaluate and interpret claims, payments, denials, accounts receivable, reimbursement trends, and other revenue cycle metrics.

• Analyze revenue cycle workflows related to registration, eligibility, charge capture, coding, billing, claims submission, payment posting, denials, and collections.

• Carry out targeted audits and reconciliations to uncover issues related to billing, payments, data integrity, and reimbursement.

• Formulate recommendations aimed at enhancing revenue capture, billing precision, collections, workflow efficiency, and regulatory compliance.

• Assist clients in implementing enhanced revenue cycle processes, policies, workflows, tools, and controls.

• Generate financial analyses, reports, dashboards, and other deliverables for client presentation.

• Collaborate with client finance, revenue cycle, operations, clinical, and IT teams.

• Offer revenue cycle expertise on various Facktor client projects.

• Engage in project-based work defined by scopes, deliverables, and timelines outlined in statements of work.

⛳️ Requirements

• Bachelor’s degree from an accredited four-year institution.

• Master’s degree is preferred; an MBA is ideal.

• Extensive professional experience in healthcare revenue cycle management, reimbursement, billing, and healthcare finance.

• Direct, hands-on experience in preparing and submitting Medicare 519 wrap rate applications for FQHCs is strongly preferred.

• In-depth knowledge of FQHC Medicare reimbursement, including PPS and supplemental/wrap payment methodologies.

• Previous experience with FQHCs or other community health centers is highly preferred.

• Proven experience in analyzing healthcare claims, reimbursement, denials, accounts receivable, and other revenue cycle data.

• Comprehensive understanding of end-to-end revenue cycle processes, from registration and eligibility to coding, charge capture, billing, claims, payment posting, denials, and collections.

• Proficiency in advanced Excel and financial/data analysis.

• Demonstrated ability to independently scope and manage defined projects, delivering high-quality results within set timelines.

• Strong problem-solving abilities, including identifying root causes and crafting practical, actionable solutions.

• Capability to convey complex reimbursement and revenue cycle concepts into clear recommendations for client leadership.

• Excellent written, verbal, and client-facing communication skills.

• Experience in providing consulting services across diverse organizations, projects, and competing priorities.

• Ability to work collaboratively and responsively with client and Facktor project teams.

• Passion for supporting non-profit organizations that provide high-quality care to underserved communities.

• Independent consulting practice and capacity to work autonomously.

• Contractor must provide their own equipment, software, workspace, and internet connectivity.

• Contractor is solely responsible for all applicable taxes, insurance coverage, and any required professional licensure or certification to perform the services.

🏝️ Benefits

• Occasional client travel may be planned and reimbursed according to relevant statements of work.

• Contractors have the flexibility to determine their own work location and schedule.

• No employee benefits are offered; the Contractor is not entitled to paid time off, sick leave accrual, stipends, insurance, or other Facktor benefits.