Sr Revenue Cycle Consultant, First Shift

Overview

The Senior Revenue Cycle Consultant serves as a key operational leader responsible for analyzing payer denial trends, managing escalations, and driving timely resolution of complex claims issues. This role oversees payer operations meetings, collaborates closely with internal revenue cycle teams, and maintains strong working relationships with payer representatives. Acting as a strategic liaison, the consultant ensures alignment between internal stakeholders and external payers to improve reimbursement outcomes and reduce avoidable denials.

United States

• Education:
  
  Minimum
  
  Required:
  
  HS diploma
• Education:
  
  Preferred:
  Bachelors degree

• License & Certification:
  Project Management Certification preferred

• Years of
  
  Experience:
  
  Minimum
  
  Required:
  
  3 - 5 Years equivalent experience

• Monitor, trend, and quantify payer denial patterns to identify emerging issues and opportunities for process improvement.
• Investigate root causes of denial trends and escalate critical issues to internal stakeholders and payer representatives to support timely resolution.
• Prepare and compile agendas, supporting materials, and follow‑up documentation for payer meetings.
• Lead and facilitate payer meetings, ensuring clear communication of issues, action items, and next steps.
• Serve as the primary liaison with payer provider representatives to address operational concerns and expedite issue resolution.
• Review payer bulletins, policy updates, and communications to identify potential impacts and support escalation or dispute of unfavorable changes.
• Comprehensive knowledge of the physician revenue cycle, including billing, denials, and payer policy interpretation.
• Exceptional organizational skills with the ability to manage multiple priorities, maintain detailed documentation, and drive accountability.
• Strong analytical mindset with the ability to interpret data and translate insights into actionable strategies.
• Ability to build and maintain productive relationships with payer representatives and internal stakeholders.