Senior Consultant / Project Manager

 

Responsibilities

  • Provide project management to MedRev healthcare clients, including national laboratories, DME, device manufacturers, hospitals, physician groups and surgical centers

  • Deliver excellent client service while leading individual or multiple project teams.  MedRev project solutions include: AR review, denial management, payment review and recovery (underpayments), identification and implementation of back-end revenue cycle improvement initiatives

  • Perform data analysis and account sampling to determine root cause issues resulting in payer underpayments and denials (including payer no response); identify recommendations for client workflow, operations and/or process changes

  • Research, develop and maintain excellent understanding of industry and payer reimbursement requirements (authorization, coding, billing, timely filing, coordination of benefits, etc.)

  • Work closely with internal resources and clients to expand MedRev expertise in client healthcare industries (laboratories, DME, device manufacturers, hospitals, physician groups and surgical centers)

  • Communicate clearly and effectively, both written and verbal, with clients and internal resources

  • Proactively communicate risks, issues, roadblocks and concerns to supervisor and/or MedRev leadership

  • Effectively prioritize tasks/projects for self and direct reports, delivering high quality results while meeting established deadlines

  • Prepare and deliver effective client presentations, clearly highlighting project success and positioning MedRev for ongoing and/or new project work

  • Develop trusted relationships with client stakeholders

  • Mentor and train less experienced MedRev staff facilitating their career development

Requirements

  • Minimum 3 to 5 years consulting experience and/or MedRev healthcare client (laboratories, DME, device manufacturers, hospitals, physician groups and surgical centers) revenue cycle experience

  • Knowledge of MedRev healthcare client revenue cycle departments (business office/PFS, HIM, managed care) and processes (underpayment identification, aged AR resolution, denials management)

  • Project Management experience leading multiple internal and client teams

  • Client relationship management experience including creation and delivery of effective/persuasive client presentations

  • Advanced skills with software including Microsoft applications – Excel, Access (SQL), Outlook, Word, PowerPoint

  • Strong quantitative, analytical and organization skills with understanding of healthcare provider financial and claims related data (billing forms, 835/837 EDI, ATB, etc.)

  • Track record and hands-on experience with significant positive results in the areas of AR & denials analysis, account resolution, developing revenue cycle recommendations and implementing process changes including successful resolution and reduction of future payer denials and underpayments

  • Knowledge and experience with payer denials including: incorrect/incomplete billing, coordination of benefits, non-participating provider, service/patient not covered, medical necessity, bundled charges, pre-cert authorization, investigational/experimental, etc.

  • Excellent communication and interpersonal skills including the ability to effectively interpret, communicate, and educate others

  • Ability to act as a team leader for multiple projects, creating a collaborative and respectful team environment

  • Superior time management skill set; ability to effectively prioritize tasks and meet deadlines

  • Self-starter; ability to work both independently and in team environments

Preferred Qualifications

  • Bachelor's degree in business, finance, programming or science/technology

  • Healthcare provider patient accounting systems experience such as Epic, XIFIN, Allscripts, Quadax, TELCOR, etc.

  • Experience with coding and claims scrubber systems

  • Experience with payer portals/adjudication systems

  • Data analysis experience including payer 276/277 claim status and 835/837 EDI

  • Data analysis/modeling experience including Excel, SQL, Tableau, Power BI, etc. (trend and pattern identification)

 

About MedRev Solutions

MedRev Solutions is a leading healthcare consultancy providing denials management, AR resolution and payment review and recovery (underpayment) services to healthcare providers nationwide.  Clients include national laboratories, DME, device manufacturers, hospitals, physician groups and surgical centers.

Utilizing MedRev services allows clients to realize significant cost/resource savings by automating appeal responses for large volumes of denied or unanswered insurance claims.  MedRev leverages client specific information to create customized algorithms and generate best in class denial response appeals.  Our proprietary software recognizes payer-specific reconsideration and appeal guidelines, layering provider/product-specifics and patient-specific clinical details to maximize insurance collections.

MedRev will quickly assess payer payment accuracy and denial data for large volumes of claims to identify patterns; findings can then be leveraged to bolster client operations and increase future internal client collections.

 

 Please submit resume to info@medrevsolutions.com