Culbert has a new opportunity for an executive level Epic data analytics consultant to serve in an interim management capacity helping one of our clients assess their current informatics/business intelligence program and define and roll out the ideal future state environment as the organization transitions to Epic. This individual must be comfortable presenting at the executive level.

Essential Duties and Responsibilities
Ideal experience includes:

• Extensive experience with the Epic clinical and revenue cycle applications, including custom configuration and data extraction for quality, financial and performance data.
• Successful completion of informatics program assessments including an evaluation of staffing size and structure, report / analytics request process, modifications to workflows.
• Scheduling Template Design
• Knowledge of not only technology (3rd party applications) but financial and clinical operations, and the necessary data governance and leadership structure required to move organizational BI programs to the next level.
• Experience advising organizations on legacy system data conversion strategies and identification of the necessary data elements that will need to be included in the warehouse for reporting purposes.

Culbert’s combination of IT and operations experience, 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 drive both operational change and Epic adoption.

Experience & Skills:
Culbert is looking for consultants with a proven track record of assisting organizations with their rapidly changing patient access needs and challenges. Examples of experience include:

• Implementation of central patient access unit / call center
• Utilization of Decision Trees
• MyChart integration and optimization
• Scheduling template re-design / standardization
• Integrating Telehealth / Virtual Visits
• “Contact-free” patient check-in protocols and workflows

Education & Requirements:

• Epic Certification in an access-related application required
• At least 3-5 years of hands-on IT or operational experience in an Epic environment
• Bachelor’s or master’s degree highly preferred
• Ability to travel weekly within the continental US
• Minimum of 80% utilization

Culbert’s athenaIDX (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 consultants to help clients implement operational best practices leveraging advanced athenaIDX functionality.

Desired Experience & Skills:
Culbert is looking for consultants who have successfully accomplished the following and can bring those accomplishments to our clients. Such achievements include but are not limited to:
athenaIDX Implementation, Optimization and Upgrade Experience

• Implementation Strategy and Project Management
• Workflow Analysis/Design
• Scheduling Template Design
• Training & Go-live Support
• Development and Execution of testing plans
• Post-live Optimization
• Upgrade Management

Application Support

• ETM design and build
• Reg/Sched/Visit Management
• BAR, HPA, CBO
• MCA/FRM
• EDM
• BI/DBMS/Reporting

Integration & Technical Services

• Connectivity Web Services
• Interface Development
• Cache programming
• Data Conversions

Education & Requirements:

• athenaIDX Experience required
• Strong understanding of operational workflows
• Bachelor’s degree highly preferred
• Ability to travel weekly within the continental US
• Minimum of 80% utilization
• Competent in Microsoft suite of Business Software, specifically Excel and PowerPoint

Culbert’s combination of Patient Access, Clinical and Revenue Cycle operations, along with our Epic application expertise, uniquely qualifies us to develop and implement innovative Epic programs which enable our clients 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 drive both operational change and Epic adoption.

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

IT Strategy & Vendor Selection

• Enterprise-Wide Patient Access, Clinical & Revenue Cycle Applications
• Return on Investment (ROI) & Total-cost-of-ownership (TCO) Analysis
• Reporting and Informatics Program Development

Organizational Redesign

• Operational & IT Governance Design
• Single Business Office Design
• Centralized Patient Access and Call Center Design

Implementation, Optimization & Upgrade Services

• Program & Project Management
• Implementation Strategy and Management
• Risk to Revenue Mitigation
• Clinical Documentation Improvement
• Upgrade Assistance
• Workflow Analysis/Design
• Training & Go-live Support
• Post-live Optimization Programs
• Meaningful-Use and PQRS program leadership

Reporting, Integration & Technical Services

• BI & Cogito Strategy
• Custom Reporting: Clarity, Reporting Workbench, Radar & Chronicles
• Interface Development (Bridges, iSirona & Ensemble)
• Cache and Visual Basic programming
• Data Conversions

Education & Requirements

• Epic Certification required
• Bachelor’s or master’s degree highly preferred
• Ability to travel weekly within the continental US
• Minimum of 80% utilization

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. 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%

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. 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