Job description
About The Wilshire Group
The Wilshire Group is a boutique consulting company firm located out of Los Angeles, California. Our firm focuses on revenue cycle optimization as well as bringing a strong leadership team as the voice between operations and IT. Our team has worked with over 100 healthcare systems across the US.
Our Values:
To be professional.
To be efficient.
To be flexible.
Position Overview
The Revenue Cycle Consultant is responsible for the direction and leadership of operational, financial, legislative, compliance, programmatic, and personnel activities for the revenue cycle, including establishing, meeting, and continuously monitoring the goals and objectives while maintaining alignment with the strategic goals and objectives for the organization. The consultant will collaborate with executive leadership to identify opportunities for improving cash flow and develops and executes business plans to maximize revenue cycle performance utilizing information technology and innovative practices.
While the range of duties and responsibilities is broad and varied, the position’s major responsibility is directing the day-to-day operations, budgeting, and financial management. The consultant works closely with a variety of stakeholders, coordinating the activities of the Revenue Cycle across the enterprise. This position assesses personnel and fiscal implications of organizational changes; assists staff in the implementation of changes; monitors and analyzes the impact of change.
Responsibilities:
Responsibilities:
- Works with executive leadership to set revenue cycle standards and performance indicators, and develop performance goals. Establishes revenue cycle organizational structure to accomplish goals and facilitate growth. Introduces innovations to maximize revenue cycle operations.
- Directly oversee and manage all aspects of the day-to-day operations of Revenue Cycle operations. This includes direct responsibility for Patient Access Services, Medical Coding/CDI, Revenue Integrity, Centralized Clinical Research Billing, and Patient Business Services. Acts as a liaison/coordinator with Finance, Reimbursement, Budget Planning, Human Resources, Marketing and Contract Negotiation, Legal, Compliance, and others.
- Leads efforts to design, develop, and implement integrated systems that ensure accurate capture, control, and reporting of patient account data. Oversees the development of policies and procedures and ensures the soundness of systems.
- Leads meetings with operations, revenue cycle management, and executive leadership. Applies advanced expertise to advise executive leadership on state-of-the-art systems, industry trends, and developments that inform the direction of revenue cycle activities.
- Maintains knowledge of all applicable regulations and standards to ensure compliance with orders or directives issued by governmental/regulatory agencies or third-party payors.
- Promotes a collaborative, service-oriented culture. Fosters open communication and innovation among staff.
- Oversee monthly and annual revenue cycle budgets, including capital planning and expenditures. Oversee all applicable vendor relationships, including non-core technology vendors, or other third-party business relationships.
- Present information and updates on Revenue Cycle development to clinical and operational leaders, CFO, Board of Directors, and other committees.
- Other duties as assigned.
- Monitor the performance of all Revenue Cycle functions including Patient Access Services, Customer Service, Centralized Research Billing, Medical Coding, Revenue Integrity, and Patient Business Services.
- Work with stakeholders to accomplish goals, objectives, and a strategic plan established for Revenue Cycle and ensure appropriate monitoring.
- Communicate effectively with staff to keep them informed of changes within and outside applicable departments.
- Develop, explain, and enforce departmental guidelines, policies, and procedures. Initiates, monitors, and enforces regulatory requirements.
- Keep current on emerging industry issues and provide timely information to staff.
- Oversee all applicable vendor relationships, including non-core technology vendors, or other third-party business relationships.
Education:
- Bachelor’s degree in healthcare, business, or related field.
- Preferred Master’s degree in business, healthcare administration, or a related field.
Work Experience:
- Minimum Eight (5) years of progressively responsible management experience in a healthcare business setting and at least three years in a directly related leadership role.
- Preferred Ten (10) or more years of management experience in a hospital business office similar in scope. Experience in a large academic or complex health program
Minimum Preferred Required Skills, Knowledge, and Abilities:
- Excellent communication and interpersonal skills including the ability to negotiate and resolve conflicts and build teams.
- Expert knowledge of healthcare revenue cycle operations, concepts, and policies with an in-depth understanding of related functions and issues, including coding, registration, billing, reimbursements, aging accounts, contractual adjustments, and charge capture.
- Exhibits advanced skills in developing and implementing strategic plans, facilitating workflow improvements, and organizing multidepartmental operations. Highly developed skills in fiscal and resource management.
- Demonstrates expert leadership and managerial skills, with the ability to create and maintain a goal-oriented climate of teamwork and collaboration to ensure consistent achievement of targets and objectives.
- Exhibits expert analytical and critical-thinking skills to synthesize data and analyze complex problems then develop and apply innovative solutions.
- Highly advanced ability to collaborate, inform and educate executives and senior leaders.
- Exhibits highly advanced communication and interpersonal skills including the ability to motivate, influence and persuade others.
- Advanced knowledge of metrics, analytics, and data synthesis in healthcare revenue cycle management to identify trends, and produce reliable forecasts and projections.
- Effective analytical ability in order to develop and analyze options, recommend solutions to, and solve complex problems and issues.
- Ability to ensure a high level of customer satisfaction including employees, patients, visitors, faculty, referring physicians, and external stakeholders.
- Demonstrated working knowledge of medical terminology associated with coding and billing. Knowledge and understanding of state and federal rules and regulations including laws regarding confidentiality, compliance, the release of information, probate and lien legislation, Fair Debt Collection Practices, and insurance regulations.
- Epic Grand Central, Resolute HB, PB, Cadence, Prelude.
Travel
- Up to 15% of travel.
Benefits
- This is a non-benefited position.
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