Revenue Integrity Consultant

1 week ago

Buffalo, New York, United States Seneca Holdings LLC Full time

Seneca Holdings LLC is a prominent entity within the Seneca Nation Group, specializing in federal government contracting. Our mission is to fulfill critical requirements for federal civilian, defense, and intelligence community clients across diverse sectors. We are proud to offer a robust benefits package, including comprehensive medical and dental coverage, a matching 401K plan, paid time off, flexible spending accounts, and disability insurance, all designed to support the financial well-being of our employees and their families.

Position Overview:

We are currently seeking a Revenue Cycle Specialist to join our team. This role is open to candidates located in the continental US, with remote work options available. The primary focus of this position is to assist our government healthcare client in the development and execution of a Revenue Integrity program.

Key Responsibilities:

  • Provide expert knowledge in MHS GENESIS Revenue Cycle, specifically in Charge Services.
  • Enhance the system's capability to deliver integrated solutions that optimize business workflows and manage costs across various healthcare settings.
  • Conduct assessments of current practices to establish a roadmap for enhancing Revenue Integrity functionalities.
  • Analyze suspended charges and Discharged Not Final Billed (DNFB) cases, utilizing a sprint framework to prioritize projects and mitigate backlog.
  • Develop and implement a scalable enterprise Revenue Cycle program.
  • Design and execute a suite of Revenue Cycle decision-support tools focused on essential Key Performance Indicators for financial health.
  • Facilitate business process re-engineering initiatives to standardize practices across all Revenue Cycle areas.
  • Apply best practices in Revenue Cycle management, including charge capture, coding, billing, reimbursement, denial management, and compliance.
  • Collaborate on training materials and workflow documentation for end users.

Basic Qualifications:

  • Bachelor's degree in a clinical or healthcare-related discipline, or an Associate degree with five years of relevant experience.
  • Ability to obtain a Favorable Suitability Adjudication through a T1 background investigation.
  • US citizenship is required due to government contract obligations.
  • In-depth knowledge of Revenue Cycle concepts and operations within the healthcare sector.
  • Strong analytical skills to interpret complex data and resolve issues related to revenue cycle integrity.
  • Effective communication and collaboration skills with team members and stakeholders.
  • Proficiency in Microsoft Office 365 (Excel, Word, PowerPoint).
  • Excellent verbal and written communication abilities.

Preferred Qualifications:

  • Current Favorable Suitability Adjudication based on a T1 background investigation.
  • Possession of a DHA issued Common Access Card (CAC).
  • Significant experience within the Military Health System (MHS) and familiarity with revenue cycle operations.
  • Proficient in various software applications for Revenue Cycle functions, including Electronic Health Record systems and data analytics tools.
  • Knowledge of MHS billing and coding policies.
  • Experience with Oracle/Cerner Electronic Health Record (EHR) systems and related reporting tools.
  • Familiarity with MHS GENESIS roles related to billing and charge analysis.

Diversity, Equity & Inclusion Commitment:

Seneca Holdings LLC is dedicated to fostering an inclusive workplace that values the diversity of our employees. We believe that an inclusive culture enhances our ability to serve our clients and positively impacts our communities.

Equal Opportunity Employment:

Seneca Holdings LLC is an equal opportunity employer, providing employment opportunities without regard to race, color, religion, sex, sexual orientation, national origin, age, disability, marital status, genetic information, or veteran status. We encourage applications from all qualified individuals, including veterans and Native individuals.

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