Description
Job Title: Healthcare Revenue Cycle Management (RCM) Consultant / Specialist
Location: Chattanooga, TN
Job Type: Part time or Contract
This role involves analyzing financial workflows, ensuring compliance with regulatory standards, and implementing strategies to enhance revenue capture, billing efficiency, and reimbursement accuracy.
Key Responsibilities:
- Evaluate and improve end-to-end revenue cycle processes, including patient registration, coding, billing, claims processing, collections, and reimbursement.
- Conduct audits and data analysis to identify inefficiencies, revenue leakage, and compliance risks.
- Develop and implement best practices to maximize revenue while maintaining regulatory compliance (e.g., HIPAA, Medicare/Medicaid regulations, payer contract requirements).
- Train and support healthcare staff in revenue cycle functions, including billing, coding, and collections.
- Monitor payer reimbursement trends, denials, and appeals processes, recommending corrective actions as needed.
- Provide insights and recommendations on revenue cycle technology solutions, including EHR/EMR systems, billing software, and automation tools.
- Assist with financial reporting, KPI tracking, and revenue forecasting to enhance operational performance.
- Ensure adherence to healthcare compliance standards, including fraud prevention, documentation accuracy, and regulatory reporting.
Requirements
Qualifications & Skills:
- Minimum of 3 years of experience in healthcare revenue cycle management, billing, coding, or consulting.
- In-depth knowledge of medical billing processes, insurance reimbursement, and healthcare payer contracts.
- Familiarity with EHR/EMR systems, revenue cycle management software, and data analytics tools.
- Strong analytical, problem-solving, and project management skills.
- Excellent communication and training abilities to work effectively with diverse healthcare teams.
- Certification in Certified Revenue Cycle Representative (CRCR), Certified Professional Coder (CPC), or Certified Healthcare Financial Professional (CHFP) is a plus.