Revenue Cycle Systems Consultant

GENERAL SUMMARY:

Serves as the primary subject matter expert connecting Epic revenue cycle technology, operational workflows, and financial performance across Community Connect partner organizations. Evaluates and optimizes revenue cycle processes, application functionality, testing activities, and workflow adoption to support accurate reimbursement, revenue integrity, and sustainable operational performance. Collaborates with partner organizations, IT teams, revenue cycle leaders, and vendors to identify risks, resolve complex issues, and implement technology-enabled solutions. Supports governance, standardization, and continuous improvement initiatives that enhance partner outcomes and support Community Connect program growth.

PRINCIPAL JOB FUNCTIONS:

1. *Commits to the mission, vision, beliefs and consistently demonstrates our core values.

1. Serves as the primary point of contact for Community Connect partners related to revenue cycle workflows, issues, and optimization opportunities.

1. Validates and monitors Epic workflows (pre- and post-go-live) to ensure accurate charge capture, coding, billing, and reimbursement outcomes.

1. Identifies and resolves revenue cycle issues at the root cause, focusing on prevention rather than downstream correction.

1. Provides IT and revenue cycle leadership for cross-functional solution design, aligning Epic build, interfaces, reporting, security, testing, and workflow decisions with operational, financial, and technical standards.

1. Evaluates the downstream revenue cycle impact of application enhancements, upgrades, interfaces, conversions, security changes, and third-party technology decisions.

1. Establishes requirements and acceptance criteria; coordinates integrated testing and user acceptance testing; verifies that solutions meet revenue cycle, operational, security, and supportability requirements.

1. Partners with application managers and analysts to prioritize defects, enhancements, technical debt, and optimization opportunities based on revenue risk, patient impact, compliance, and strategic value.

1. Conducts regular rounding with partner sites to assess workflow adherence, identify risks, and provide proactive guidance.

1. Analyzes trends in denials, missed charges, charge lag, and other performance indicators, escalating risks and recommending corrective actions.

1. Leads revenue cycle technology readiness, integrated testing, cutover planning, go-live support, and post-go-live stabilization, with focus on workflow adoption, system performance, revenue integrity, and transition to sustainable support.

1. Facilitates decision-making and coordination among partner leaders, Bryan Health IT and revenue cycle teams, Epic application teams, vendors, and other technical stakeholders; escalates material risks and recommends action to leadership.

1. Provides education and guidance to partner staff on revenue cycle processes, Epic functionality, and best practices.

1. Leads the development and standardization of technology-enabled workflows, policies, support models, governance standards, testing requirements, and documentation across Community Connect partners.

1. Represents IT and revenue cycle interests in governance, change control, performance reviews, prioritization, strategic planning, vendor discussions, and optimization initiatives.

1. Maintains executive-ready documentation of risks, decisions, dependencies, issues, resolutions, technical standards, and performance trends to support accountability, scalability, and consistency.

1. Maintains professional growth and development through seminars, workshops, and professional affiliations to keep abreast of latest trends in field of expertise.

1. Participates in meetings, committees and department projects as assigned.

1. Performs other related projects and duties as assigned.

(Essential Job functions are marked with an asterisk "*").

REQUIRED KNOWLEDGE, SKILLS AND ABILITIES:

1. Knowledge of end-to-end revenue cycle operations, including scheduling, registration, coding, charge capture, billing, claims management, denials, reimbursement, and revenue integrity.

1. Knowledge of Epic revenue cycle applications and cross-application workflows, including Resolute Hospital Billing, Resolute Professional Billing, Cadence, Prelude, and related integration and reporting dependencies.

1. Knowledge of healthcare regulatory requirements, including CMS regulations, payer guidelines, and HIPAA compliance requirements.

1. Knowledge of charge capture methodologies, revenue integrity principles, workflow optimization, and process standardization practices.

1. Knowledge of healthcare information technology principles, including application lifecycle management, systems integration, testing, release management, change management, incident management, problem management, security, data governance, and vendor coordination.

1. Knowledge of computer hardware equipment and software applications relevant to work functions.

1. Skill in analyzing operational, financial, and system performance data to identify trends, risks, and opportunities and develop actionable recommendations.

1. Skill in communicating technical, operational, and financial concepts effectively to diverse audiences through verbal, written, and presentation formats.

1. Skill in providing functional leadership and facilitating collaboration across IT, clinical, operational, financial, vendor, and partner stakeholders.

1. Skill in systems thinking, root cause analysis, risk assessment, prioritization, and decision-making within complex technical and operational environments.

1. Ability to influence decisions, build consensus, and drive outcomes without direct authority in a matrixed environment.

1. Ability to identify workflow, system, and operational risks and implement proactive solutions that improve performance and prevent downstream issues.

1. Ability to establish and maintain effective working relationships with partner organizations, vendors, and internal stakeholders at all organizational levels.

1. Ability to adapt to evolving technologies, workflows, and business needs while supporting scalable program growth and continuous improvement initiatives.

1. Ability to communicate effectively both verbally and in writing.

1. Ability to perform crucial conversations with desired outcomes.

1. Ability to problem solve and engage independent critical thinking skills.

1. Ability to maintain confidentiality relevant to sensitive information.

1. Ability to prioritize work demands and work with minimal supervision.

1. Ability to maintain regular and punctual attendance.

EDUCATION AND EXPERIENCE:

Bachelor's degree in information technology, computer science, healthcare administration, business, finance, health information management, or related field required. Master's degree preferred. Minimum seven (7) years of progressively responsible experience in healthcare information technology, Epic revenue cycle applications, revenue cycle operations, healthcare finance, physician practice operations, or related healthcare environment required. Minimum three (3) years of project, functional, technical, operational, or cross-functional leadership experience within an Epic revenue cycle or comparable enterprise healthcare technology environment required. Experience leading complex initiatives involving system implementations, application optimization, integrated testing, workflow redesign, governance, change management, and technology-enabled revenue cycle transformation required. Experience supporting ambulatory, hospital, physician practice, Community Connect, multi-entity, or matrixed healthcare organizations required.

OTHER CREDENTIALS / CERTIFICATIONS:

Epic certification or accreditation in at least one applicable revenue cycle application (e.g., Resolute Hospital Billing, Resolute Professional Billing, Cadence, or Prelude) required at hire or within twelve (12) months of employment. Professional revenue cycle certification (e.g., HFMA CRCR or CHFP, AAHAM CRCE or CRCP, AAPC, AHIMA, or equivalent) required at hire or within eighteen (18) months of employment. Maintains required Epic and professional revenue cycle credentials in active status and completes applicable continuing education and recertification requirements.

PHYSICAL REQUIREMENTS:

(Physical Requirements are based on federal criteria and assigned by Human Resources upon review of the Principal Job Functions.)

(DOT) - Characterized as sedentary work requiring exertion up to 10 pounds of force occasionally and/or a negligible amount of force frequently to lift, carry, push, pull, or otherwise move objects, including the human body.