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Job Details

Job Title : Revenue Cycle Business Process Consultant - Denials

Posted On : 01/17/2024

Duties:
In addition to the following, this role focuses on a specific area of the PATIENT-CENTRIC REVENUE CYCLE ROADMAP (graphic attached).
Denials

Strictly Denials Focused - finding interventions to prevent denials.
Moreover, this role will entail an element of cross functional team leadership within which project management, process improvement, stakeholder alignment (executives), change management, and significant Rev Cycle EPIC experience are critical. In lieu of certs, requisite EPIC experience will be explored.

JOB SUMMARY
The Revenue Cycle Business Consultant supports revenue cycle processes that span multiple departments, multiple workflows and systems or supports analytic efforts of the revenue cycle through report development, data quality assurance, process mapping and analysis. The position also supports business process improvement efforts including projects to enhance Epic, automation, quality, and efficiency through report writing, analysis, business case development and data validation

JOB FUNCTIONS
Revenue Process Support, Workflows and Systems

• Develop and maintain written documentation for processes that exist between departments, systems, external vendors and payers.
• Act as a high-level business process consultant between operations, performance improvement and IT for needs that cross boundaries. Implement processes and practices that can adapt quickly to changing organization, business, and payer demands. The position does not replace normal relationships between various departments but rather acts as a compliment to existing relationships to enhance and expedite performance improvement activities.
• Reviews business process, system or other changes that might impact existing workflows and recommends methods to optimize to desired state and improve efficiency. Review system or process architecture in scope of assigned projects.
• Perform business impact reviews of test plans that span across departments, workflows or systems or to assess impact, efficiency and effectiveness.
• Create, optimize, and support the implementation of processes that link closely to system workflows. Determine how these workflows will impact existing staffing, how to continuously refresh and monitor these flows and recommend optimal change management processes.
• Communicate information clearly and create an environment where people can engage in open dialogue and reach effective solutions together to optimize workflow or process.
• Direct cross-functional teams to resolve complex issues related to automated workflows or other complex processes or lead discussions with the business and operational leaders to analyze reporting needs, configure and model data and develop reports using specialized knowledge of reporting applications and software applications.

Data Reporting and Analysis
• Responsible for creating and managing the financial and operational reports generated on regular and an ad hoc basis using software applications for report writing and data warehousing; provides consultation and assistance to ensure end users and operational reporting needs are met through report development and design.
• Primary liaison to various internal and external user groups within facility in terms of revenue cycle data reporting and analysis. Assist revenue cycle leadership, management, and staff in analyzing, interpreting, and presenting data and information to various parties.
• Develop and build reporting solutions that monitor and benchmark cost, utilization and other quality and performance indicators; Act as primary support to senior leadership in accessing relevant data necessary to develop strategic and operational business plans, and process improvements.
• Develop business case analysis to support process optimization and change.
• Perform troubleshooting, problem solving activities related to business intelligence reporting as necessary. Analyze data and reports to understand business impact, correlations/discrepancies, and to propose changes/alternate solutions. Work closely with the Information Technology teams to resolve issues and perform analysis in a timely manner.

Knowledge, Skills and Abilities
Project Management
Change Managmenet
Process Improvement
Cross-Functional Team Leadership   
Epic Reporting       
Epic Design Exp (Not Building/ Coding)         
Epic Rev Cycle Experience Required         
Strong analytical and communication skills    Required
Strong computer skills to include database analysis    Required
Statistical software experience    Preferred
Extensive knowledge of workflow and/or system design    Required
Extensive knowledge of analytical tools, business intelligence tools and statistical packages    Required

Education
Bachelor's Degree Required

Work Experience
At least five (5) years experience with system design, process workflow design or business/systems consulting.  Required   
EPIC experience Required
Epic Mechanics how it works
Revenue Cycle experience  Required   

Licenses, Certifications, and Registrations

EPIC certification    EPIC        Preferred   
Lean Six Sigma Green Belt (LSSGB)    Lean Six Sigma Green Belt - LSSGB - American Society for Quality        Preferred 


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