Revenue Cycle Operations Consultant

Revenue Cycle Operations Consultant Internal Only Location Coeur d'Alene, ID Facility Kootenai Health Department Revenue Cycle - Operations Schedule/Shift/Hours Full Time - Days Category Technical/Professional Hours Per Pay Period 80 = 1.0 Req #: 47681

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29361 Position Summary The Revenue Cycle Operations Consultant serves as a subject matter expert responsible for overseeing and optimizing revenue cycle processes while ensuring compliance with federal, state, and payer-specific regulations. This position works cross-functionally with clinical, financial, and operational teams to identify gaps, drive process improvements, and support the strategic goals of the organization. Responsibilities

• Represents the Revenue Cycle at enterprise-level meetings, committees, and multidisciplinary forums
• Leads and manages Revenue Cycle projects from initiation through completion, ensuring scope, timelines, deliverables, and compliance requirements are met
• Develops and maintains project charters, work plans, timelines, milestones, and status reporting for Revenue Cycle initiatives
• Establishes project governance, including stakeholder alignment, risk identification, issue escalation, and dependency management
• Facilitates regular project status updates and executive communications, ensuring visibility, accountability, and alignment with organizational priorities
• Conducts root cause analyses of Revenue Cycle performance issues, identify operational gaps, compliance risks, and process breakdowns
• Prepares, analyzes, and presents monthly Revenue Cycle KPIs, dashboards, and performance metrics to leadership and up to Executive level, including trends and recommended actions
• Tracks project outcomes post-implementation to validate effectiveness, sustainability, and compliance adherence, recommending course corrections as needed
• Ensures Revenue Cycle processes comply with federal, state, and payer-specific regulations, including billing, coding, charging, and reimbursement requirements
• Serves as a subject matter expert on Revenue Cycle workflows, regulatory guidance, and compliance standards
• Monitors, reviews, and audits billing, coding, and claims processes for accuracy, consistency, and regulatory adherence
• Identifies operational gaps and recommends compliance-driven process improvements across the Revenue Cycle
• Collaborates with clinical, financial, operational, and IT teams to implement system changes, workflow enhancements, and Revenue Cycle initiatives
• Develops, updates, and maintains Revenue Cycle policies, procedures, and internal controls
• Analyzes Revenue Cycle data to identify trends, risks, revenue opportunities, and performance improvement strategies
• Provides education and guidance to staff on regulatory updates, compliance requirements, and operational best practices
• Supports leadership with strategic planning, regulatory readiness, and execution of Revenue Cycle goals
• Updates and maintains the Revenue Cycle Teams page, ensuring content accuracy, consistency, and accessibility
• Leads Revenue Integrity enterprise level projects partnering with clinical, financial, operational, and IT leaders to drive compliant outcomes
• Relies on experience and judgment to plan and accomplish goals
• Regular and predictable attendance is an essential job function
• Performs other related duties as assigned
• Competent to meet age-specific needs of the unit assigned Requirements and Minimum Qualifications
• Minimum 5 years' related experience in the healthcare industry
• Project Management Certification required, with demonstrated experience leading complex, multi-department healthcare initiatives
• Bachelor's degree required; 2 years' related healthcare experience may be accepted in lieu of degree in addition to experience requirement
• Healthcare compliance certification (e.g., CHC, CRC, CRCP) required within one year of hire
• Demonstrated expertise in regulatory compliance, charge capture, billing accuracy, revenue leakage prevention, and risk mitigation
• Strong project management skills, including scope development, stakeholder alignment, timeline management, issue escalation, and delivery of measurable results Working Conditions
• Must be able to lift and move up to 10 lbs
• Must be able to communicate and exchange accurate information
• Must be able to maintain a sitting position
• Typical equipment used in an office job

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