Revenue Cycle Management (RCM) Consultant (Contract)
About The Position
Phamily, Jaan Health’s core technology platform, is seeking an experienced Revenue Cycle Management (RCM) Consultant for a one-month contract assignment, with an option to extend. The consultant will bring expertise in healthcare insurance billing, medical coding, claims auditing, and reimbursement optimization. They will partner with Phamily’s internal teams and healthcare system clients to evaluate billing accuracy, identify revenue leakage, resolve claims discrepancies, and improve reimbursement outcomes. This is a hands-on role requiring independent claims audits, assessment of billing and coding practices, identification of operational gaps, and actionable recommendations to help clients accurately capture reimbursement for eligible services. The role is remote, with travel to client sites of up to 20% as assigned, and reports to the Senior Director, Managed Services. The stated pay rate is $30.00–$40.00 per hour. Jaan Health is an AI-based care management company serving healthcare providers. Its Phamily platform supports proactive chronic disease care, helping providers deliver individualized care and receive compensation for eligible care between office visits. The company describes itself as fast-growing and early-stage, with a collaborative team and a culture guided by care, curiosity, clarity, co-creation, and craftsmanship.
Requirements
- At least 5 years of hands-on experience in healthcare revenue cycle management, insurance billing, medical coding, claims auditing, or reimbursement consulting.
- In-depth experience with Epic, Oracle Health/Cerner, or other EHR and billing platforms.
- Extensive expertise in Medicare, Medicaid, and commercial insurance billing and reimbursement requirements.
- Advanced knowledge of CPT, HCPCS, ICD-10-CM coding, modifiers, and payer-specific billing rules.
- Proven experience independently auditing medical claims, identifying coding errors, and resolving reimbursement discrepancies.
- Demonstrated ability to identify revenue leakage, reduce denials, and improve billing accuracy and reimbursement outcomes.
- Experience working with healthcare systems, physician groups, medical practices, or healthcare revenue cycle organizations.
- Strong analytical skills, including the ability to review complex billing data, identify trends, and translate findings into actionable recommendations.
- Ability to work independently, manage consulting deliverables, and communicate effectively with internal stakeholders and healthcare system clients.
- Proven success in a high-performing environment, with high velocity, strong ownership, comfort with ambiguity, resilience, and a growth mindset.
- Ability to design scalable approaches and follow through on delivering results.
Responsibilities
- Conduct detailed audits of medical claims, billing records, coding, and supporting clinical documentation.
- Validate CPT, HCPCS, and ICD-10-CM codes, modifiers, and payer-specific billing requirements.
- Identify inaccurate coding, missed charges, duplicate billing, underbilling, and other reimbursement discrepancies.
- Verify that claims meet Medicare, Medicaid, and commercial payer billing and documentation requirements.
- Evaluate end-to-end billing workflows, including charge capture, claims submission, denials, and payment reconciliation.
- Identify revenue leakage, missed reimbursement opportunities, and operational inefficiencies.
- Analyze denied, rejected, and underpaid claims to determine root causes and recommend corrective actions.
- Recommend improvements to billing accuracy, clean claim rates, and reimbursement capture.
- Serve as a billing and reimbursement subject matter expert for Phamily’s healthcare system clients.
- Partner with client revenue cycle and billing teams to investigate and resolve billing discrepancies.
- Evaluate client billing practices and recommend improvements to accuracy, compliance, and reimbursement.
- Support client discussions about coding, documentation, payer requirements, and billing processes.
- Provide guidance on CMS regulations, Medicare billing guidelines, and commercial payer requirements.
- Assess billing compliance risks and recommend corrective actions.
- Develop standardized claims audit procedures, quality assurance controls, and billing best practices.
- Collaborate with Clinical Operations, Product, Technology, and Finance teams to improve billing workflows and supporting documentation.
Stand Out From the Crowd
Upload your resume and get instant feedback on how well it matches this job.
What This Job Offers
Career Level
Mid Level
Education Level
No Education Listed
