Responsible for growing and developing a robust revenue cycle service line for the firm. Emphasis on acquiring new business through personal and team business development efforts as well as maintaining current client base
Serves as both a role model and trainer in helping new team members develop technical and professional competency
Planning, scoping, developing, and leading projects, including developing work plans that comply with Wipfli policies and methodologies.
Leading interviews with client process owners to understand current state systems, processes, and/or controls and assessing risk with minimal oversight and supervision.
Evaluating design and operating effectiveness of chart reviews, including efficiency, effectiveness, and mitigating controls, and procedures to remediate gaps.
Preparing chart review reports on findings and recommendations to senior management.
Reviewing deliverables, chart review work papers, and other supporting process documentation for quality.
Communicating strengths and weaknesses to the client or internal project management team and developing effective solutions.
Ensuring timely completion of assigned project phases within a provided budget.
Exhibiting strong ethical behavior and strong morals.
Developing tools necessary to perform job duties when needed
Developing and maintaining effective client relationships.
10+ years in a healthcare provider industry (or relevant experience in professional services), preferably in areas such as patient financial services, reimbursement, compliance or internal audit.
Bachelor’s Degree in relevant discipline (e.g. Accounting, Finance, Information Technology or Business Related Field) desired.
Consulting experience and experience in hospitals, physician practices, RHCs and FQHCs
Needs strong contacts in the CA market, and business development experience.
Prior experience in the healthcare industry, preferably provider operations including hospitals, physician practices and ancillary services.
Understanding of revenue cycle operations and revenue cycle accounting principles.
Strong knowledge in CMS requirements for reimbursement
Knowledge of the Health Insurance Portability and Accountability Act (HIPAA), Stark, Anti-kickback and other industry-relevant compliance requirements.
Provider billing and reimbursement, including revenue recognition and accounts receivable management
General knowledge of healthcare provider operations, including hospitals, physician practices, home health, hospice, skilled nursing
Relevant regulatory knowledge within the industry including, but not limited to: CMS, OIG, HIPAA, ACA etc.
Key healthcare provider processes including, but not limited to: charge capture, billing, collections, compliance, patient access, medical records, payer contracts, physician relationships, financial operations, foundation, etc.
Project management, supervisory, leadership, and mentoring experience.
Ability to interpret payer contracts
Strong analytical and problem-solving skills.
Advanced verbal and written communication skills including documentation of findings and recommendations.
Strong listening skills to discern the best course of action for our clients.
Understanding of commonly used internal control concepts
Knowledge of chart review processes and methodologies, including developing process flows.
Travel throughout the month frequently required based upon client requests/commitments. Travel may include suburban, regional, or out of state locations.