Senior Revenue Integrity Consultant

Reports to:  Chi-Matic Staff Manager

About Chi-Matic

Chi-Matic (pronounced ‘shy-mat-ick’) is a boutique consulting firm focused on guiding health systems through large technology implementations, assisting revenue cycle leadership in streamlining business processes with the use of technology resulting in improvements in cash collected or reduction in cost to collect. Based out of Madison, Wisconsin, our team has worked with over 125 healthcare organizations around the country to build thriving programs through collaborative planning, successful implementation, and metric-driven optimization.

Our Values

Individualized Growth | Accountability | Integrity | Curiosity | No Fear of Failure

Job Overview

Chi-Matic is looking for top quality Revenue Integrity experts with 7+ years experience in Revenue Integrity.  This consultant will develop and support key Revenue Integrity initiatives necessary for the long term success of Chi-Matic’s clients.  The Senior Revenue Integrity Consultant is a catalyst for continuous improvement in the Revenue Integrity department, tasked with improving revenue capture while maintaining compliance with laws and regulations.

Responsibilities and Duties

The Senior Revenue Integrity Consultant will:

  • Develop charge capture policies and procedures that facilitate systematic revenue cycle operational improvements as well as compliance with governmental and third-party requirements in collaboration with the client
  • Provide expertise in guiding charge capture and reconciliation process process redesign 
  • Perform CDM maintenance and lead CDM pricing and change process management 
  • Operationalize regulatory and payor requirements leveraging technology and workflow solutions as necessary. Ensure departments adhere to compliance requirements in a timely manner.
  • Works with PFS leadership to evaluate revenue cycle metric impacts due to Revenue Integrity initiatives.
  • Direct and execute in complex projects related to revenue cycle initiatives for the hospital system in the following areas, : 
    • Clinical charge capture workflows and reconciliation
    • CDM Maintenance
    • Hospital Billing Revenue Guardian Checks
    • Pricing adjustments
    • Cost Center Mapping

Required Qualifications:

  • Bachelor’s degree in Business, Management, Healthcare, or related discipline required. 
  • 7-10 years related work experience required.
  • 5 years supervisory/management experience preferred.
  • In depth knowledge of CPT/HCPCS coding; advanced knowledge of multiple reimbursement systems including IPPS, OPPS and fee schedules
  • In depth knowledge of applicable regulatory bodies that drive charge capture and billing practices
  • Extensive knowledge of charge creation, regulation, charge capture and reconciliation in an health care environment using Epic
  • Demonstrates working knowledge of revenue cycle processes, medical billing and coding processes, quantitative decision making, and process analysis
  • Extensive coding and/or clinical knowledge
  • Advanced skills with Microsoft applications which may include Outlook, Word, Excel, PowerPoint or Access and other web-based applications. May produce complex documents, perform analysis, and maintain databases
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