Consultant, Revenue Cycle Regulatory and Compliance

HealthPartners•Brainerd, MN

5d•$36 - $55

About The Position

Manage and coordinate system-wide regulatory and payor requirements to ensure compliant billing practices within revenue cycle. Perform regular internal audit reviews to ensure compliant billing and reporting regulations are being followed. Create and maintain tools and databases for tracking projects and proactively review regulatory filings. Keep current on regulatory requirements, such as 855 enrollments and state data submission requirements. Maintain time-sensitive processes and meet organizational deadlines. Collaboration with key stakeholders, including but not limited to Revenue Cycle teams, Legal, Compliance, IT, and care group leaders to analyze and interpret data and policy in efforts to identify solutions and resolve under minimal risk. Ability to stay up to date on policy and process changes with CMS, commercial payors, and federal/state legislation. This role is system-wide and may consist of both facility and professional claim types, including but not limited to rural health, critical access, and acute care, as well as MN/WI state variations.

Requirements

Bachelor’s degree; or equivalent work experience
3+ years working with healthcare revenue cycle or within other highly regulated processes.
Highly skilled with standard office computing applications such as Microsoft 365, especially Excel
Ability to convert complex subject matter to accessible information for all colleagues
Ability to self-motivate, take initiative and engage in critical thinking
Excellent analytical and creative problem-solving abilities
Task-oriented, with excellent follow through; patience and persistence.
Excellent writing and communication skills
Excellent organizational and time-management skills
Strong commitment to accuracy and attention to detail
Ability to work in a fast-paced environment, adapt to changing conditions, and meet deadlines
Ability to work across departments with a collaborative, responsive, respectful approach
Ability to become a trusted partner

Nice To Haves

Master’s degree
2+ years’ experience with Medicare billing/regulatory experience
2+ years’ experience monitoring healthcare payor bulletins and legislative changes
Healthcare Financial Management Association - Certified Revenue Cycle Representative (CRCR)
Ability to translate CMS billing regulations and requirements for acute care, critical access and rural health facilities into appropriate billing practice

Responsibilities

Manage and coordinate system-wide regulatory and payor requirements to ensure compliant billing practices within revenue cycle.
Perform regular internal audit reviews to ensure compliant billing and reporting regulations are being followed.
Create and maintain tools and databases for tracking projects and proactively review regulatory filings.
Keep current on regulatory requirements, such as 855 enrollments and state data submission requirements.
Maintain time-sensitive processes and meet organizational deadlines.
Collaborate with key stakeholders, including but not limited to Revenue Cycle teams, Legal, Compliance, IT, and care group leaders to analyze and interpret data and policy in efforts to identify solutions and resolve under minimal risk.
Stay up to date on policy and process changes with CMS, commercial payors, and federal/state legislation.