Business Process Consultant - Revenue Assurance (Remote)

Duke Careers•Durham, NC

12d•Remote

About The Position

At Duke Health, we're driven by a commitment to compassionate care that changes the lives of patients, their loved ones, and the greater community. No matter where your talents lie, join us and discover how we can advance health together. About Duke Health's Patient Revenue Management Organization Pursue your passion for caring with the Patient Revenue Management Organization, which is Duke Health's fully integrated, centralized revenue cycle organization that supports the entire health system in streamlining the revenue cycle. This includes scheduling, registration, coding, billing, and other essential revenue functions. Duke University Health System - Patient Revenue Management Office (PRMO) seeks to hire a Business Process Consultant who will embrace our mission of Advancing Health Together. The Business Process Consultant (BPC) serves as the primary analytical resource supporting all revenue cycle processes, systems and workflow. The BPC is a subject matter expert in Epic (Maestro Care), data analytics, payer reimbursement and demonstrates a broad spectrum of operational expertise across many areas of the Revenue Cycle. The BPC supports the Revenue Cycle departments and operational leaders within the Patient Revenue Management Organization (PRMO) by identifying opportunities to improve operational efficiency and performance. The BPC has a system focus through monitoring of dashboards and key metrics to pro-actively identify, analyze, and trend issues. The BPC strategically supports operations by identifying opportunities to improve workflow and effectiveness through projects and innovative solutions to enhance automation, quality and efficiency through enhancement requests, report writing, analysis and business case development and data validation.

Requirements

Bachelor's degree required. Master's degree preferred.
Minimum of 7 years work experience. Extensive knowledge of Revenue Cycle analytical tools, business intelligence tools and statistical packages. Proven experience with Revenue Cycle workflows to include but not limited to overall claims processing spanning the life cycle of the revenue cycle, denials management, insurance follow up, and net collection rate impacts and calculations.
Experience can be supplemented with Master's degree with a Masters being equivalent to two years of experience
Knowledge of:
Epic System (Revenue Cycle Applications)
Revenue Cycle operations
Ability to:
Understand revenue cycle operational performance goals/metrics
Strong analytical skills
Perform root cause analysis with accuracy
Identify and implement optimization opportunities within Epic
Investigate and analyze information and provide recommend solutions for identified issues
Develop, implement and oversee project teams comprised of IT and operational resources
Communicate effectively, both orally and in writing
Demonstrate strong interpersonal and communication skills
Work effectively with a wide range of constituencies in a diverse community
Foster a positive work environment
Multi-task
Systems
Epic
MS Office Applications (Word, Excel, Visio, PowerPoint)

Responsibilities

Identification and Analysis of Financial Opportunities:
Identify existing and future revenue cycle-based improvement opportunities
Lead PRMO discussions, evaluations, selections and prioritization of improvement opportunities, including the development of an ROI analysis to better understand and determine potential impact on overall PRMO performance
Work closely with PRMO leadership to understand operational goals and challenges to identify opportunities for enhancements
Perform and prepare regular root cause analysis of performance of the revenue cycle function to identify areas of opportunity utilizing various data systems including Slicer Dicer and Tableau
Responsible for various standard, recurring reporting functions to support revenue cycle operational business needs
Assists revenue cycle senior leaders in working closely with organizational stakeholders to improve financial performance based on analytic findings
Monitor key performance indicators for internal and external parties
Cultivates internal relationships to assist in understanding department workflows
Provides analytics for and supports special projects as needed (e.g. new payer policy financial impact)
Support investigation into claims/denials patterns, payer policy changes, collection rate shifts, avoidable write-off’s, and payer mix evaluation to optimize payer performance.
Develop analytical models that are well-documented containing advanced formulas and functions that are used to evaluate historical trends, forecast future expectations, or draw conclusions
Point person for month-end Revenue Cycle Net Revenue Review
Revenue Cycle Strategic Initiatives and Project Management:
Create, design, lead, and implement strategies that will reduce AR, improve aging AR, improve net collection rate, eliminate waste through automation or optimization of workﬂows, reduce denials, and reduce avoidable write -oﬀs, for all areas of the Revenue Cycle
Develop, maintain, and enhance knowledge of Revenue Cycle systems and third-party vendors to support recommendations for optimal workﬂows.
Leverage technology and best practices to recommend process improvements
Collaboration:
Eﬀectively communicate trends to inﬂuence all levels of leadership for process improvements
Partner with leaders and teams to review and establish improvement opportunities
Perform project management duties to align multi-disciplinary groups across the revenue cycle and clinical departments, corporate ﬁnance, DHTS, and hospital service line leadership
Communicate and track progress of identiﬁed issues and action items
Partner with Operations Improvement on outstanding optimization and automation projects
Other:
Promote PRMO strategic vision, mission, and purpose while emphasizing teamwork and results.
Create and foster a department culture that provides a satisfying and enriching environment in which staﬀ can be developed and retained.
Interact with and provide timely verbal/written responses to all stakeholders (patients, providers, payors, and departmental personnel).
Acknowledge management requests and emails in a professional, timely manner.
Attend meetings and participate in Work Culture initiatives, committees or workgroups, as assigned.
Accomplish all tasks as assigned.