Revenue Cycle Denials Consultant – Project Management

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

📋 Description

• Evaluate existing denial processes, workflows, and overall performance.

• Analyze denial patterns to uncover root causes, opportunities, and financial risks.

• Create and execute strategies aimed at minimizing preventable denials and enhancing revenue cycle performance.

• Oversee denial-related projects from the initial planning phase to implementation.

• Formulate project plans, timelines, milestones, deliverables, and status updates.

• Coordinate activities among revenue cycle teams and key stakeholders.

• Facilitate project meetings and communicate updates on progress, risks, issues, and opportunities.

• Monitor project outcomes and ensure initiatives remain on schedule.

• Assess denial data and generate actionable recommendations.

• Collaborate with operational leaders and revenue cycle stakeholders to enhance processes.

• Identify opportunities for improvement in workflows, payer processes, authorizations, coding, billing, and upstream activities.

• Assist in the development and execution of denial prevention strategies.

• Track key performance indicators and evaluate the impact of improvement initiatives.

• Support the creation of standard operating procedures, workflows, and process documentation.

• Provide expertise in revenue cycle denials and share best practices.

• Present findings and recommendations to both operational and executive stakeholders.

⛳️ Requirements

• Over 7 years of experience in healthcare revenue cycle management, with a strong focus on denials management.

• In-depth understanding of the complete revenue cycle and the denials management process.

• Demonstrated experience in identifying denial trends and conducting root-cause analyses.

• Proven track record in developing and applying denial prevention and reduction strategies.

• Required project management experience.

• Capability to manage several project workstreams, timelines, and deliverables simultaneously.

• Strong analytical and problem-solving abilities.

• Experience with revenue cycle data, reporting, and performance metrics.

• Comprehensive understanding of payer requirements and denial/appeal processes.

• Exceptional written and verbal communication skills.

• Ability to work independently in a consulting environment while effectively collaborating with client teams.

• Strong organizational skills and keen attention to detail.

• Proficient in articulating complex revenue cycle issues and recommendations to executive and operational stakeholders.

• Preferred: experience in leading revenue cycle transformation or optimization projects.

• Preferred: background with large health systems or complex healthcare organizations.

• Preferred: familiarity with Epic or other major EHR/PM systems.

• Formal project management certification such as PMP, CAPM, or an equivalent is advantageous.

• A Bachelor's degree in healthcare administration, business, finance, or a related field is preferred.

🏝️ Benefits

• Opportunity to leverage healthcare expertise in impactful consulting projects.

• Collaborate with a team knowledgeable in the healthcare sector.