Revenue Integrity Consultant
A leading healthcare consulting firm is seeking a Revenue Integrity Consultant to join its growing Revenue Integrity practice. This role offers the opportunity to work directly with hospitals, health systems, and healthcare organizations on high-impact revenue cycle and performance improvement initiatives. The position combines strategic consulting, operational transformation, financial analysis, and client leadership, making it an excellent opportunity for professionals looking to expand their influence across complex healthcare environments.
Location
- Remote with travel required based on client needs
- Approximately 50% travel
Qualifications
- 5+ years of consulting and/or healthcare industry experience within Revenue Integrity, Charge Integrity, Revenue Cycle, or related functions
- Experience leading performance improvement, process redesign, reimbursement optimization, and revenue recovery initiatives
- Strong knowledge of Revenue Integrity operations, including charge capture, charge reconciliation, charging compliance, denials prevention, pricing, reimbursement, and Charge Description Master (CDM) management
- Working knowledge of Medicare reimbursement methodologies, including IPPS, OPPS, and ASC payment systems
- Understanding of healthcare charging, coding, billing, reimbursement, and compliance requirements
- Experience evaluating clinical documentation, charge capture, and revenue cycle workflows
- Strong analytical, financial modeling, project management, and client-facing communication skills
- Experience presenting findings and recommendations to executive stakeholders, including CFOs, Revenue Cycle leaders, Compliance leaders, and operational executives
- Bachelor's degree required; advanced degree preferred
- Industry certifications such as RHIA, RHIT, CPC, COC, CCS, CRIP, or similar credentials are preferred
- Experience with healthcare technology platforms such as Epic, Cerner/Oracle Health, MEDITECH, Allscripts, Athenahealth, or related systems preferred
Responsibilities
- Lead Revenue Integrity engagements focused on revenue optimization, compliance improvement, and operational transformation
- Assess charge capture, charge generation, and revenue cycle workflows to identify financial and operational opportunities
- Conduct current-state assessments and develop actionable recommendations and implementation roadmaps
- Analyze financial, operational, and transactional data to identify revenue leakage and performance improvement opportunities
- Develop financial models, business cases, and executive-level recommendations for healthcare clients
- Design and implement future-state Revenue Integrity processes, governance structures, controls, and monitoring programs
- Lead project teams, manage engagement timelines, budgets, and deliverables, and ensure successful project execution
- Develop and maintain relationships with client executives and key stakeholders throughout engagements
- Present findings, recommendations, and project results to senior healthcare leadership
- Support business development initiatives and contribute to the continued growth of the consulting practice
- Collaborate with multidisciplinary teams across revenue cycle, operational improvement, managed care, and healthcare transformation projects
This is an excellent opportunity for a Revenue Integrity professional who enjoys solving complex healthcare challenges, leading client engagements, and driving measurable financial and operational improvements across provider organizations.
FAQs
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