Revenue Cycle Denials Consultant – Project Management

Job not on LinkedIn

🔥 58 minutes ago

🏄 California – Remote

🏄 California – Remote

💵 $80 / hour

⏳ Contract/Temporary

🟠 Senior

🔴 Lead

👷‍♀️ Project Manager

👻 Ghost score 1%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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The Wilshire Group

WebsiteLinkedInAll Job Openings

11 - 50 employees

🏥 Healthcare

⚕️ Healthcare Insurance

💼 Consulting

Healthcare • Healthcare Insurance • Consulting

The Wilshire Group is a consultancy firm that specializes in optimizing revenue cycle operations and IT solutions for the healthcare industry. They provide services in patient access, health information management, revenue integrity, and billing for both hospital and professional settings. The firm focuses on enhancing financial experiences by partnering with clients to solve complex challenges at the intersection of operations and technology. The Wilshire Group is dedicated to helping organizations maximize their EHR investments and improve revenue recognition and workflow optimization, ensuring consistent and proven results.

📋 Description

• Assess current denials processes, workflows, and performance • Analyze denial trends and identify root causes, opportunities, and financial risks • Develop and implement strategies to reduce preventable denials and improve revenue cycle performance • Lead denials-related projects from planning through implementation • Develop project plans, timelines, milestones, deliverables, and status reporting • Coordinate activities across revenue cycle teams and key stakeholders • Facilitate project meetings and communicate progress, risks, issues, and opportunities • Monitor project deliverables and keep initiatives on track • Evaluate denial data and develop actionable recommendations • Partner with operational leaders and revenue cycle stakeholders on process improvements • Identify workflow, payer process, authorization, coding, billing, and upstream improvement opportunities • Support denial prevention strategy development and implementation • Track KPIs and measure improvement initiative impact • Assist with SOPs, workflows, and process documentation • Provide revenue cycle denials subject matter expertise and best practices • Communicate findings and recommendations to operational and executive stakeholders

🎯 Requirements

• 7+ years of healthcare revenue cycle experience, with significant experience in denials management • Strong knowledge of the end-to-end revenue cycle and denials management process • Experience identifying denial trends and performing root-cause analysis • Experience developing and implementing denial prevention and reduction strategies • Project management experience required • Ability to manage multiple project workstreams, timelines, and deliverables • Strong analytical and problem-solving skills • Experience with revenue cycle data, reporting, and performance metrics • Strong understanding of payer requirements and denial/appeal processes • Excellent written and verbal communication skills • Ability to work independently in a consulting environment while collaborating with client teams • Strong organizational skills and attention to detail • Ability to communicate complex revenue cycle issues and recommendations to executive and operational stakeholders • Preferred: experience leading revenue cycle transformation or optimization projects • Preferred: experience with large health systems or complex healthcare organizations • Preferred: experience with Epic or other major EHR/PM systems • Formal project management certification such as PMP, CAPM, or equivalent is a plus • Bachelor's degree in healthcare administration, business, finance, or a related field is preferred

🏖️ Benefits

• Opportunity to apply healthcare expertise to meaningful consulting engagements • Work alongside a team experienced in the healthcare environment