Senior Consultant- Revenue Cycle Management jobs in United States
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Plante Moran · 2 days ago

Senior Consultant- Revenue Cycle Management

Plante Moran is a leading audit, tax, consulting, and wealth management firm that prioritizes employee growth and well-being. They are seeking an experienced Senior Consultant specializing in middle revenue cycle functions to provide strategic guidance and optimize revenue integrity and compliance in healthcare settings.

AccountingConsultingFinancial ServicesInsuranceTax ConsultingWealth Management
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Growth Opportunities
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Responsibilities

Conduct thorough reviews of charge capture processes to ensure accuracy and compliance with regulatory standards
Identify and rectify discrepancies in charge entries to prevent revenue leakage
Collaborate with clinical departments to enhance charge capture accuracy
Provide guidance to clients on coding processes to ensure adherence to ICD-10, CPT, and HCPCS coding guidelines
Perform regular audits to identify and correct coding errors
Lead CDI initiatives to improve the quality and completeness of clinical documentation
Work closely with physicians and clinical staff to ensure documentation accurately reflects the patient's clinical status and care provided
Implement CDI best practices and monitor their effectiveness
Review and verify the medical necessity of services provided to ensure compliance with payer requirements
Develop and implement processes to streamline medical necessity verification
Educate clinical staff on documentation requirements for medical necessity
Analyze and manage denials to identify root causes and implement corrective actions
Develop strategies to reduce denial rates and improve the appeals process
Collaborate with payers to resolve complex denial issues
Provide expert consulting services to clients, offering strategic recommendations to optimize their revenue cycle processes
Develop and maintain strong client relationships, ensuring high levels of client satisfaction
Prepare and present detailed reports and analyses to clients and senior management

Qualification

Revenue Cycle ManagementCharge ValidationClinical Documentation ImprovementCoding Guidelines ICD-10Coding Guidelines CPTCoding Guidelines HCPCSCertified Professional Coder (CPC)Healthcare Regulations KnowledgeRCM Software ProficiencyAnalytical SkillsProblem-Solving SkillsCommunication SkillsTeamworkIndependent Work

Required

Bachelor's degree in Business, Healthcare Administration, or a related field
Minimum of 3 years of experience in revenue cycle management, with a focus on middle revenue cycle functions
Strong knowledge of healthcare regulations, including HIPAA, CMS guidelines, and payer policies
Excellent analytical, problem-solving, and communication skills
Ability to work independently and as part of a team in a fast-paced environment
Proficiency in using RCM software and tools

Preferred

Master's degree
Prior experience at a reputable RCM consulting firm
Certified Professional Coder (CPC) or Certified Coding Specialist (CCS) certification

Benefits

Health, dental, vision, disability, and life insurance
Flexible Time Off
Various pre-determined holidays
401(k) plan
Flexible benefits plans
Business-related travel expense
Lodging, and meal reimbursement for business-related use
A pension plan is also available for eligible administrative and paraprofessional staff
A discretionary bonus plan is available for eligible staff
Plante Moran also offers some contingent staff positions the option to elect health insurance in addition to limited paid sick time

Company

Plante Moran

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Plante Moran is an accounting and business advisory firm that offers audit, accounting, tax, and business advisory consulting services.

Funding

Current Stage
Late Stage

Leadership Team

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Gordon Krater
Retired Partner
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Steve Schenbeck
Partner
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