Revenue Integrity Consultant

Client Delivery (Hands-On Execution Focus)

• Assessments & Audits: Perform detailed revenue integrity assessments across hospital and/or physician revenue cycle operations. Execute comprehensive audits of charge capture, coding, documentation, billing, and reimbursement processes.
• Stakeholder Collaboration: Work directly with client staff (HIM, coding, revenue cycle, finance, and clinical departments) to resolve issues in real time.
• Relationship Management: Serve as a day-to-day client contact, building strong, trusted relationships across all organizational levels.

Revenue Recovery & Optimization

• Financial Identification: Identify and quantify missed revenue opportunities, underpayments, and process gaps.
• Recovery Efforts: Participate in or lead revenue recovery efforts, including retrospective reviews, rebilling, and appeals support.
• Workflow Optimization: Evaluate and optimize the Charge Description Master (CDM) and charging workflows. Analyze denials and determine root causes to prevent recurring issues.

Implementation & Results Ownership

• Execution Strategy: Support the execution and implementation of recommendations-focusing on practical, operational application rather than just high-level strategy.
• ROI Tracking: Develop practical, tailored solutions that fit each client’s operational realities. Track and report realized financial impact and ROI.
• Sustainability: Assist in building sustainable processes, internal controls, and monitoring tools.

Data Analysis & Reporting

• Data Mining: Analyze complex client data sets to identify trends, anomalies, and performance gaps.
• Dashboards & Reporting: Build clear, client-ready reports and dashboards to tell a compelling financial and operational story using data.

Firm Contribution

• Business Development: Support business development efforts, including proposal input, scoping, and client presentations.
• IP Development: Contribute to the development of proprietary tools, methodologies, and internal intellectual property.
• Mentorship: Mentor junior staff and collaborate effectively within small, high-performing teams.

Do you have experience in Stakeholder relationship building?, Do you have a Bachelor’s degree?, The Revenue Integrity Consultant plays a key role in delivering high-impact, hands-on consulting services to healthcare clients. Operating within a fast-paced boutique firm environment, this position requires deep subject matter expertise, strong analytical capabilities, and the ability to independently manage workstreams while collaborating closely with clients and internal leadership.Consultants are expected to not only identify revenue opportunities but also actively support implementation and deliver measurable financial results., Education & Certifications

• Degree: Bachelor’s degree in Health Information Management (HIM), Healthcare Administration, Finance, or a related field required.
• Required Professional Certifications (At least one or more):
• RHIA (Registered Health Information Administrator) or RHIT (Registered Health Information Technician)
• CCS (Certified Coding Specialist), CPC (Certified Professional Coder), or equivalent coding certification
• Preferred Certifications: CHC (Certified in Healthcare Compliance) or CHFP (Certified Healthcare Financial Professional) are a strong plus.

Professional Experience

• 4-8+ years of hands-on healthcare revenue cycle or revenue integrity experience.
• Strong preference given to candidates with:
• Direct hospital or health system experience
• A proven track record in audit and/or revenue recovery work
• Prior healthcare consulting experience

Skills & Competencies

Technical Expertise

• Deep knowledge of charge capture processes and coding systems (ICD-10, CPT, HCPCS).
• Strong understanding of reimbursement methodologies (DRG, APC, OPPS, and professional billing).
• Hands-on experience with major EHRs (Epic, Cerner, Meditech) and standard revenue cycle systems.

Analytical & Core Strengths

• Advanced Excel Skills: Mastery of pivot tables, VLOOKUPs, and advanced data analysis tools to connect datasets to financial outcomes.
• Self-Starter Mindset: Ability to work independently with minimal structure, take initiative, and “roll up your sleeves” to execute tasks.
• Attention to Detail: Meticulous focus on accuracy, compliance, and regulatory standards.

Client-Facing Communication

• Ability to communicate financial and technical findings clearly to both frontline staff and health system executives.
• Strong interpersonal skills to build trust quickly in a consultant-client dynamic.

3.63.6 out of 5 stars Illinois Remote $70 - $85 an hour - Contract