Available Positions - Culbert Healthcare

Revenue Integrity – Senior Consultants

We are currently looking for Revenue Integrity experts who have experience across the Revenue Integrity functions including development and maintenance of charge description master (CDM), managing charge integrity between the CDM and hospital departments, researching coding, billing and revenue opportunities, reporting charge capture and revenue trends, and overall improving reimbursement while ensuring regulatory compliance.
Experience working with Epic, Cerner, GE and Allscripts in academic and integrated delivery environments is highly desired. Read More

If you are a results driven leader with extensive revenue cycle management experience and have a demonstrated ability to billing performance and the patient experience, let’s connect at talent@culberthealth.com.

Work you’ll do
Participate in the design and development of new Revenue Integrity programs

Researches and resolves CPT and HCPCS codes, revenue codes, and other issues.
Maintains the CDM by incorporating new charges/services identified by the departments, third-party changes, CMS regulations, federal and state specific coding updates.
Performs a detailed, annual review of the CDM that includes identifying CPT and HCPCS codes that have been deleted, added, or replaced; assigns CPT and HCPCS specific codes when appropriate, identifies description changes, ensures the nomenclature reflects the procedures performed, and maintains an audit trail of all changes.
Verifying adherence to charge posting policies and procedures, ensuring compliance with required governmental laws, regulations, contractual requirements, standards and practices both related to the systems charge master.
Keeps abreast of changing industry requirements and regulations regarding acceptable documentation and billing practices by reviewing Federal Register, fraud alerts, OIG advisory opinions and other relevant publications. Communicates changes to impacted leaders and provides education on such changes.
Establishes and performs periodic billing/claim audits based on CDM complexity and risk.
Responds to outside compliance questions, complaints, and inquiries related to CDM items.
Partners with departments and executive leadership to recommend and communicate additions, changes, opportunities, and audit results.
Coordinates meetings with department managers, staff and/or physicians regarding new program and procedure developments, equipment acquisitions and validation of inactive codes. Serves as a resource to hospital departments for implementation or regulatory questions.
Monitors revenue and usage reports daily for anomalies and researches issues. Reviews late charge reports for optimization and efficiency opportunities. Completes and provides other management reports as requested. Routinely reviews revenue recognitions processes across the organization through facilitation of Revenue Review Team.
Works with Managed Care to recommend terms and conditions and charge increases with consideration of improving reimbursement.
Distributes correspondence of third-party requirements for coding changes to departments for review of the impeding changes.
Provides assistance, coordination and education on Revenue Integrity related issues.
Provides technical assistance and oversight for charging of new services and strategic pricing initiatives. Identifies services that are reimbursable, but not being coded.
Determines charge and charge attributes for new services and products.
Identifies services that are reimbursable but are not being coded; reviews, assigns and validates revenue codes. Coordinates adjustments to the current market pricing position to meet organizational goals.

Qualifications

Bachelor’s degree required with a Master’s degree highly preferred
Minimum of 8 years of professional experience in revenue cycle operations in a health care provider, consulting, or technology vendor environment
Demonstrates consistent career progression with increasing levels of responsibility
Competent in Microsoft suite of Business Software, specifically Excel and PowerPoint
Knowledge regarding CPT and HCPCS coding and UB revenue code assignments.
Knowledge of billing and reimbursement processes and methodologies.
A strong working knowledge of government payer programs and reimbursement methodologies (CMS, AHCCCS, etc.) and of managed care programs. Required
Willingness and ability to travel 100%

Revenue Cycle Consultants

As the healthcare industry faces increasing financial pressures from evolving reimbursement models, government regulations, Accountable Care Organizations, and healthcare reform, it has never been more important for physicians and hospitals to optimize the efficiency and effectiveness of revenue cycle performance. Culbert’s Revenue Cycle practice provides comprehensive solutions to maximize performance, increase efficiencies and enhance the overall patient experience. We are looking for consultants with Epic, GE (Athena), Allscripts and Cerner experience. Read More

Desired Experience & Skills:
Culbert is looking for consultants who can successfully prove to accomplish the following and can bring those accomplishments to our clients. Examples of experience include:

- - Revenue Cycle Assessment
    - Thorough Review of front and backend operations
    - Workflow analysis and redesign
    - Performance metrics and benchmarking
    - Revenue cycle systems review including EHR charge capture
    - Identification and prioritization of opportunities for improvement
    - Implementation action plan
    - Staffing size, structure & benchmarking
  - Billing System Management & Optimization
    - System implementation project management
    - Implementation of advanced functionality
    - Remote and onsite application support
    - Custom report writing
  - Charge Data Master, Coding & Compliance Review
    - Physician Education
    - Coding and compliance audits
    - EHR form/template assessment
    - Code scrubber technologies
  - Interim Revenue Cycle Management
    - Executive leadership
    - Supervisors
    - Third-party contracting and settlement negotiations
    - Vendor selection for outsourced billing management
  - Development of Central Patient Access & Revenue Cycle Functions
    - Single business office for professional & hospital services
    - Central patient access unit for registration & scheduling
    - Standardized policies & procedures
  - Extended Billing Office Functions
    - A/R remediation
    - Settlement negotiations with payers
    - Denial Resolution
    - Cash Acceleration

Education & Requirements:

- - Bachelor’s degree in a business or healthcare management discipline required. A master’s degree in a business or healthcare management discipline is highly preferred. Consideration will be given to exceptional candidates without a degree with 10 or more years of experience in revenue cycle management at the manager level or higher.
  - Professional billing systems certification preferred.
  - Epic Resolute HB and/or PB Certification/Experience preferred.
  - Ability to travel weekly within the continental US (typical work week is Monday – Thursday, 4 ten hour days onsite)

Submittal
Interested candidates should send their resumes to talent@culberthealth.com

athenahealth Centricity (formerly GE Centricity) Business Consultants

Culbert’s athenahealth Centricity (formerly GE Centricity) team collaborates with our clients on the implementation and optimization of their patient access and revenue cycle solutions with highly-knowledgeable and experienced Centricity expertise to help clients implement operational best practices leveraging advanced Centricity functionality. Read More

Epic Consulting Services

Culbert’s combination of Patient Access, Clinical and Revenue Cycle operations combined with our Epic application expertise uniquely qualifies us to develop and implement innovative Epic programs which enable our client to successfully navigate the changing healthcare landscape. Our Epic Consulting Team, comprised of seasoned professionals cross-certified in multiple Epic applications, leverages proven best practices to maximize learning and minimize operational risk to drive both operational change and Epic adoption. Read More

Regional Sales Executive

Culbert Healthcare Solutions is looking to add a top-performing Regional Sales Executive to our organization. This individual will be responsible for working with client executives including, CEOs, COOs, CFOs, CIO’s, CMIO’s, as well as Patient Access and Revenue Cycle Leaders to promote our service offerings with academic medical centers, integrated delivery networks, hospitals and medical group organizations.

The Regional Sales Executive is responsible for the development and execution of prospecting and sales strategies, management of pipeline activities, development and delivery of proposals and client presentations, and account management. Read More

Job Responsibilities Include, but are not limited to;

Prospecting for new customers, in addition to expanding the business generated from existing client base. Development of long-term client relationships.
Managing entire sales cycle from prospecting and lead generation through completing RFPs and proposals, delivering client presentations, negotiating sales and closing deals, and exhibiting at industry related conferences.
Develop and maintain a detailed knowledge of our consulting service offering, industry trends, partner vendors, and competitors.
Interface with management team to identify resource needs and assist in the recruitment process.
Achieve annual performance goals in terms of sales volume and gross margins.

Qualifications:

Proven track record of selling professional services in the healthcare industry
Excellent communication skills, including writing and presenting.
Experience using CRM tools, such as Salesforce.com
Bachelors degree
Demonstrated ability to work collaboratively in sales environment
Ability to travel
Unrestricted work authorization in the United States

About the company:
Culbert Healthcare Solutions provides professional consulting services to hospitals, academic medical centers and large group practices. Our singular focus is to help our clients utilize best practices and technology to improve patientcare, enhance patient experience and to drive financial performance.

Our experts have interconnected experience across all of our service areas, Management Consulting, Clinical Advisory, Health-IT, enabling Culbert to deliver integrated and cohesive solutions to the challenges that face the healthcare industry today. It has always been our philosophy and practice to invest in on-going training and development of our fully–employed staff, which translates directly to the quality of service we are able to consistently provide to clients nation-wide.

Submittal
Interested candidates should send their resumes to talent@culberthealth.com