Netsmart RCM (Revenue Cycle Management) ConsultantLocation: Remote
Employment Type: Full-Time and Part-Time Opportunities Available
Compensation: Commensurate with Experience
Position SummaryThe
Netsmart RCM Consultant serves as a subject matter expert in Netsmart EHR revenue cycle functionality and Human Services revenue cycle operations, with particular emphasis on
myAvatar and/or myEvolv.
This role works directly with client financial, billing, clinical, operational, and technical teams to evaluate revenue cycle performance, identify root causes of revenue leakage or delays, optimize Netsmart configurations and workflows, and develop sustainable improvements across the revenue cycle.
The successful candidate will understand that many revenue cycle problems do not begin in the billing department. Issues involving intake, eligibility, authorizations, clinical documentation, workflow design, system configuration, coding, claims submission, denials, and follow-up can all affect an organization's ability to capture revenue accurately and efficiently.
Key ResponsibilitiesEHR and Revenue Cycle Assessment & Optimization- Assess clients' existing Netsmart EHR configurations, workflows, and revenue cycle processes.
- Evaluate the complete revenue cycle from intake and registration through authorization, clinical documentation, coding, claims submission, payment posting, denial management, and collections.
- Identify system, workflow, configuration, documentation, and process issues that contribute to delayed or lost revenue.
- Recommend practical improvements that align Netsmart functionality with organizational, clinical, operational, and financial requirements.
- Support Netsmart EHR optimization, reconfiguration, implementation, and improvement initiatives.
- Provide support during implementations, optimization projects, testing, and go-live activities as needed.
Revenue Cycle Management- Analyze claims processing, payment cycles, reimbursement patterns, denials, and accounts receivable trends to identify improvement opportunities.
- Work closely with finance, billing, coding, clinical, and operational teams to align workflows with payer and reimbursement requirements.
- Identify the root causes of recurring denials and recommend corrective actions.
- Evaluate opportunities to automate or streamline processes to reduce manual effort, rework, errors, and revenue delays.
- Help clients strengthen processes surrounding eligibility, authorizations, documentation, coding, billing, and collections.
- Recommend strategies to improve clean-claim rates, reduce denials, accelerate reimbursement, and strengthen overall revenue-cycle performance.
Workflow & Process Improvement- Analyze current-state workflows and identify bottlenecks, gaps, workarounds, and inconsistencies affecting revenue performance.
- Facilitate workflow discussions with clinical, operational, financial, and technical stakeholders.
- Develop recommendations for improved future-state workflows.
- Help ensure that EHR configuration supports the organization's actual operational and clinical processes.
- Evaluate downstream financial consequences when clinical or operational workflows are not functioning as intended.
Training, Adoption & Change Management- Develop and deliver training for billing teams, clinicians, administrative staff, managers, and other users.
- Educate staff on Netsmart workflows, documentation requirements, and processes that affect billing and reimbursement.
- Support Organizational Change Management initiatives associated with revenue-cycle and EHR process improvements.
- Help organizations move from temporary workarounds to consistent, sustainable workflows.
- Provide post-implementation and optimization support as appropriate.
Reporting & Performance Improvement- Develop, review, and interpret reports used to monitor revenue-cycle performance.
- Establish and monitor relevant KPIs, including denial rates, clean-claim rates, days in accounts receivable, reimbursement trends, and other financial performance measures.
- Use data to identify trends, bottlenecks, and improvement opportunities.
- Present findings and recommendations to client leadership in a clear, actionable manner.
- Help clients develop greater visibility into how EHR workflows affect financial performance.
Compliance & Best Practices- Help ensure workflows and system usage support applicable healthcare regulations, payer requirements, documentation standards, and organizational policies.
- Maintain working knowledge of relevant coding and reimbursement requirements, including ICD-10, CPT, and HCPCS.
- Assist clients in preparing for or responding to billing, coding, documentation, and revenue-cycle audits.
- Identify potential compliance or revenue risks and recommend appropriate corrective actions.
Client Collaboration & Consulting- Serve as a trusted advisor to client financial, clinical, operational, technical, and executive stakeholders.
- Act as a bridge between departments when EHR or workflow issues cross functional boundaries.
- Facilitate communication between clinical and administrative teams to improve documentation, coding, billing, and reimbursement processes.
- Clearly communicate findings, risks, priorities, and recommendations to client leadership.
- Build and maintain strong client relationships throughout engagements.
Required Qualifications- 3-5+ years of experience with Netsmart EHR systems, revenue cycle management, Human Services operations, healthcare IT consulting, or a closely related field.
- Demonstrated hands-on experience with Netsmart myAvatar and/or myEvolv.
- Strong understanding of healthcare and Human Services revenue-cycle processes.
- Experience with healthcare billing, claims, denials, coding, reimbursement, and collections.
- Working knowledge of ICD-10, CPT, and HCPCS.
- Experience analyzing workflows and identifying operational or system-related problems.
- Strong analytical and problem-solving skills.
- Strong client-facing consulting, facilitation, and communication skills.
- Ability to work collaboratively across financial, clinical, operational, and technical teams.
- Ability to translate complex revenue-cycle or system issues into understandable, actionable recommendations.
Preferred Qualifications- Bachelor's degree in Healthcare Administration, Health Information Management, Information Technology, Finance, Business, or a related field.
- Experience specifically within Human Services, behavioral health, intellectual and developmental disabilities, addiction treatment, or other community-based care environments.
- Experience with Netsmart implementations, optimization, re-implementations, or system assessments.
- Experience with Organizational Change Management and workflow redesign.
- Experience developing and interpreting revenue-cycle dashboards and performance metrics.
- Certified Revenue Cycle Professional (CRCP), Certified Healthcare Financial Professional (CHFP), CPHIMS, or another relevant professional certification.
Key Skills & Competencies- Netsmart myAvatar and/or myEvolv expertise
- Revenue Cycle Management
- Claims and denial management
- Billing and reimbursement
- Revenue-cycle analysis
- Workflow assessment and optimization
- Root-cause analysis
- EHR implementation and optimization
- Human Services operations
- Healthcare documentation and coding
- Organizational Change Management
- Data analysis and KPI reporting
- Client relationship management
- Training and facilitation
- Cross-functional collaboration
- Problem solving and critical thinking
- Executive-level communication
