Tegria logo
Tegria

Transforming Healthcare Together

Back-End Revenue Cycle Consultant

Backend EngineerSoftware EngineerFull TimeRemoteMid LevelTeam 1,001-5,000Since 2020H1B SponsorCompany SiteLinkedIn

Location

United States

Posted

107 days ago

Salary

$110K - $135K / year

Seniority

Mid Level

Job Description

Back-End Revenue Cycle Consultant

Tegria

You provide expertise in healthcare revenue cycle management systems and operations to enhance our clients’ efficiency and maximize their revenue. Assess, implement, modify, and optimize revenue cycle management systems, technologies, financial operations and processes to enhance revenue cycle performance. Build and modify systems to comply with healthcare regulations, coding guidelines, and billing standards. As a Tegria consultant, you guide healthcare clients in using technology to achieve their unique goals. You contribute to a range of engagements—from strategy and implementations to process improvement, working independently or as part of a team. You may lead a project or juggle multiple priorities. Beyond client work, you mentor team members, support internal efforts, and contribute to business growth. Your ability to think strategically, communicate clearly, and adapt quickly drives success for clients and Tegria alike. Core Responsibilities - Collaborate with clinical, IT, and administrative leaders to ensure alignment of revenue cycle goals and system capabilities. - Assess the functionality and performance of revenue cycle applications (e.g., Epic Resolute, Cerner, Meditech). - May evaluate existing revenue cycle processes (e.g., registration, billing, coding, collections) to identify inefficiencies, compliance issues, and revenue leakage. - Map and redesign end-to-end revenue cycle workflows (from scheduling to collections) to align with system capabilities and business goals. - Recommend and implement best practices, configuration changes, or system enhancements to improve cash flow, reduce denials, and enhance user experience. - Streamline workflows and automate manual processes using EHR and revenue cycle management tools. - Ensure clinical documentation and charge capture workflows are integrated and optimized within EHR systems. - Identify and correct disconnects between services rendered and charges billed. - Lead or support the implementation and optimization of revenue cycle technologies or modules (e.g., charge capture, claims management, denial tracking). - Coordinate system testing (unit, integrated, user acceptance) and validate interfaces between clinical and financial systems. - Facilitate integration between EHRs, billing systems, clearinghouses, and external payer platforms to ensure accurate and timely flow of data. - Design and deliver custom reports and dashboards for revenue cycle KPIs using tools like Crystal Reports, Tableau, or Power BI. - Use data analysis to identify trends in denials, underpayments, and workflow bottlenecks. - Serve as a subject matter expert (SME) during go-lives and provide post-implementation support. - Configure systems and workflows to ensure compliance with federal and state regulations, payer policies, and billing requirements (e.g., ICD-10, CPT, HIPAA, CMS rules). - Monitor audit trails and implement controls to safeguard revenue. - Provide guidance on billing and coding accuracy to prevent audit risks. - Liaise with software vendors and third-party consultants. - Track milestones, risks, and progress using project management tools Client Delivery & Engagement - Deliver high-quality, impactful consulting services. - Serve in various roles—project lead, team member, or independent contributor. - Understand client challenges and goals; offer solution options that align with client preferences. - Collaborate with teams to meet timelines, hit milestones, and ensure seamless execution. - Mediate between stakeholders to resolve conflicts and align outcomes. - Communicate clearly and proactively; manage expectations and prevent miscommunication. - Track and communicate key decisions; support change management to minimize disruptions. Process & Solution Implementation - Document current processes, identify gaps, and recommend improvements. - Build, test, train, and implement interfaces, configuration, infrastructure, workflows, or policies; ensure accuracy and reliability. - Create personal work plans to ensure timely, high-quality results. - Measure and report on the impact of your work to demonstrate value. Risk & Issue Management - Identify and escalate risks related to scope, timeline, or resources. - Develop and communicate mitigation plans and flag potential obstacles early. Client Enablement & Knowledge Transfer - Mentor client teams to build their capabilities and long-term ownership. - May develop training materials and conduct sessions for front-end, mid-cycle, and back-end users on new systems and workflows. - Ensure alignment on priorities, pacing, and next steps; verify understanding throughout. Strategic Alignment - Execute work in line with service line strategy. Internal Team Support - Mentor and support less experienced team members. - Share tools, methods, and expertise to support service line innovation. - Contribute to internal projects that support Tegria’s strategic goals. Sales and Business Development - Identify and share business development opportunities during engagements. - Leverage your network and expertise to surface potential leads. - Develop content to support sales and marketing efforts as needed - Contributes to pursuit opportunities. Required Qualifications Education - BA/BS in healthcare or business administration, or information systems or an equivalent combination of education and experience Certifications - Back End Revenue Cycle consultant with relevant Epic certifications (HB and PB) Experience - Typically, 5+ years of relevant experience as consultant, senior-level analyst or manager in hospital revenue cycle operations and related systems. Prior experience in a billable consulting position preferred. - Experienced in systems analysis, project management and change management. - Experienced a major new system implementation, preferred. Knowledge - Fully competent in the focus area, specifically: - Regulations and standards related to healthcare revenue cycle operations - Financial and operational controls - Healthcare Revenue Cycle processes - Healthcare Revenue Cycle systems such as EHR’s and patient financial systems - Solid understanding of the consultant’s role, methods and tools. - Continuously stay informed about the latest trends, tools, and regulations in their areas of expertise. - Understands modern project management frameworks such as Agile or Scrum to manage workflows and deliver incremental improvements (preferred). Skills, able to: - Work independently and lead small teams with minimal supervision and wide latitude for independent judgement. - Apply appropriate project and systems analysis tools (e.g., milestone charts, data flow diagrams, interviews, flowcharts, status reports) to support planning and execution. - Translate business needs into clear, actionable technical deliverables. - Communicate complex technical and business concepts clearly through written, visual, and verbal means. - Facilitate group decision-making, build consensus, and develop communication strategies to support change. - Drive project momentum, especially during uncertainty or at-risk milestones. - Manage time and priorities effectively to meet deadlines and objectives. - Anticipate and plan for the impact of changes through structured change management. - Collaborate cross-functionally while maintaining respect for role boundaries. - Use Office 365 and collaboration tools proficiently. Success Characteristics People who are successful in this role: - Model company values. - Are productive, responsive, and reliable in a remote working environment. - Are accountable for their actions, decisions and responsibilities. - Maintain a high standard for the quality of their own and others’ work. - Establish rapport and credibility with clients and colleagues by demonstrating expertise, reliability, and integrity. - Apply best practices and concepts from similar work to new scenarios. - Appreciate the good work and contribution of others. - Display exceptional resilience, adaptability, resourcefulness, and determination. Salary Range $110,000 - $135,000 Now, a little about us … At Tegria, we bring bold ideas and breakthroughs to improve care, technology, revenue, and operations in ways that move healthcare organizations from patient-centered to human-centered. We are helping healthcare put people first—both patients and those who dedicate their lives to delivering care. And at the very core of this vital work is our incredibly talented people. People with different backgrounds who welcome challenge and change. People who listen first, ask hard questions, and make decisions to cultivate a culture of equity and inclusion. People who chase after goals, growth, and generosity. We’re real. We’re nimble, and we believe in our mission to humanize healthcare. Perks and benefits Top talent deserves top rewards. We’ve carefully curated a best-in-class benefits package, meant to meet you wherever you are in your life and career. - Your health, holistically. We offer a choice of multiple health and dental plans with nationally recognized networks, as well as vision benefits, a total wellness program, and an employee assistance program for you and your family. - Your financial well-being. We offer competitive wages, retirement savings plans, company-paid disability and life insurance, pre-tax savings opportunities (HSA and/or FSA), and more. - And everything in between. Our lifestyle benefits are unrivaled, including professional development offerings, opportunities for remote work, and our favorite: a generous paid-time-off program, giving you the flexibility to plan a vacation, take time away for illness (or life’s important events), and shift your schedule to accommodate those unexpected curve balls thrown your way. Tegria is an equal employment opportunity employer and provides equal employment opportunities (EEO) to all persons regardless of age, color, national origin, citizenship status, physical or mental disability, race, religion, creed, gender, sex, sexual orientation, gender identity and/or expression, genetic information, marital status, status with regard to public assistance, veteran status, or any other characteristic protected by federal, state or local law. All qualified candidates are encouraged to apply.

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