The Wilshire Group is a boutique consulting company firm located out of Los Angeles, California. Our firm focuses on revenue cycle optimization as well as bringing a strong leadership team as the voice between operations and IT. Our team has worked with over 100 healthcare systems across the US.
The Revenue Cycle Consultant is responsible for the direction and leadership of operational, financial, legislative, compliance, programmatic, and personnel activities for the revenue cycle, including establishing, meeting, and continuously monitoring the goals and objectives while maintaining alignment with the strategic goals and objectives for the organization. The consultant will collaborate with executive leadership to identify opportunities for improving cash flow and develops and executes business plans to maximize revenue cycle performance utilizing information technology and innovative practices.
Responsibilities:
- Works with executive leadership to set revenue cycle standards, performance indicators, and develop performance goals.
- Establishes revenue cycle organizational structure to accomplish goals and facilitate growth.
- Introduces innovations to maximize revenue cycle operations.
- Directly oversee and manage all aspects of the day-to-day operations of Revenue Cycle operations.
- Acts as a liaison/coordinator with Finance, Reimbursement, Budget Planning, Human Resources, Marketing and Contract Negotiation, Legal, Compliance and others.
- Leads efforts to design, develop, and implement integrated systems that ensure accurate capture, control and reporting of patient account data.
- Oversees the development of policies and procedures and ensures soundness of systems.
- Leads meetings with operations, revenue cycle management and executive leadership.
- Applies advanced expertise to advise executive leadership on state-of-the-art systems, industry trends and developments that inform the direction of revenue cycle activities.
- Maintains knowledge of all applicable regulations and standards to ensure compliance with orders or directives issued by governmental / regulatory agencies or third party payors.
- Promotes a collaborative, service-oriented culture.
- Fosters open communication and innovation among staff.
- Oversee monthly and annual revenue cycle budget, including capital planning and expenditures.
- Oversee all applicable vendor relationships, including non-core technology vendors, or other third party business relationships.
- Present information and updates on Revenue Cycle development to clinical and operational leaders, CFO, Board of Directors, and other committees
- Monitor the performance of all Revenue Cycle functions including Patient Access Services, Customer Service, Centralized Research Billing, Medical Coding, Revenue Integrity and Patient Business Services.
- Work with stakeholders to accomplish goals, objectives and a strategic plan established for Revenue Cycle and ensure appropriate monitoring
- Communicate effectively with staff to keep them informed of changes within and outside applicable departments
- Develop, explain and enforce departmental guidelines, policies and procedures.
- Initiates, monitors and enforces regulatory requirements
- Keep current on emerging industry issues and provide timely information to staff
- Oversee all applicable vendor relationships, including non-core technology vendors, or other third party business relationships
