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Sr Business Consultant - Revenue Cycle, Professional Billing & Physician Support

Description:

Department Overview: Operational Effectiveness The Operational Effectiveness team supports both the Physician Practice Groups (PPG) and PB Operations, driving performance through strategic process improvement and revenue cycle (RC) management.

Role-Specific Responsibilities:

Physician Practice Groups (PPG) Front-End RC Management

Train front-end staff on registration workflows, insurance eligibility, and pre-authorization protocolsEducate users on resolving claim edit errors and interpreting real-time eligibility responsesConduct monthly KPI report-outs tailored to assigned specialties, focusing on registration, eligibility, and denial trendsIdentify and address front-end process gaps to enhance revenue cycle performance

PB Operations Back-End RC Management

Lead initiatives to improve operational efficiencies through structured process improvement methodologiesTrack and analyze issues and opportunities across the revenue cycleGather detailed data and stakeholder input to support targeted improvement effortsFacilitate cross-functional collaboration to implement sustainable solutions

RESPONSIBLE FOR:
Responsible for identifying, leading and facilitating Revenue Cycle Operational Effectiveness and performance improvement initiatives in collaboration with operations without direct supervisory responsibility over team members. Responsible for scoping projects, developing project plans and assisting with implementing solutions. This also includes, initiating, executing and managing Revenue Cycle Operational Effectiveness initiatives, research, quality assurance activities and related projects. Additionally, this role will serve as the leads for development of training content to support the operational improvements identified. As an internal consultant and knowledge expert related to Revenue Cycle, the work will span the course of operational and financial areas and will be determined based on use of Lean methodology for areas in need of process improvement, improved results, project management and/or oversight such as development of processes, work flow analysis, strategic planning and business plan development as well as other areas requiring attention. He/she leads operational research and root-cause investigations based on stakeholder requests; collaborates with operational stakeholders in the development and design of operational changes that will create revenue opportunities and drive best in class patient experiences; and ensures reliability, sustainability, spread and use of industry best practices and benchmarks.

Qualifications:

MINIMUM EDUCATION REQUIRED:
Bachelor's degree in Business Administration, Healthcare Administration, or a related field is required.

MINIMUM EXPERIENCE REQUIRED:
Three (3) years of progressively responsible project management or process improvement experience.

MINIMUM LICENSURE/CERTIFICATION REQUIRED BY LAW:
None.

ADDITIONAL QUALIFICATIONS:
Masters degree preferred.
Proven understanding of revenue cycle operations and technology.
Certification in Lean, Six Sigma or similar improvement methodologies strongly preferred.
Superior written and verbal communication skills including the ability to present ideas in a clear and compelling manner to both executive and staff level audiences.
Previous experience using or implementing Epic is desired.

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