What are the responsibilities and job description for the Physician Revenue Cycle Consultant position at ScionHealth?
Description
At ScionHealth, we empower our caregivers to do what they do best. We value every voice by caring deeply for every patient and each other. We show courage by running toward the challenge and we lean into new ideas by embracing curiosity and question asking. Together, we create our culture by living our values in our day-to-day interactions with our patients and teammates.
Job Summary
The Regional Coordinator – Physician Revenue Cycle serves as a key liaison between facility-based operations and centralized billing functions, supporting multiple sites to optimize revenue cycle performance. This role focuses on accounts receivable management, denial resolution, charge capture integrity, and charge description master (CDM) maintenance. The Coordinator partners with clinical, operational, and billing stakeholders to standardize processes, improve compliance, reduce revenue leakage, and enhance reimbursement outcomes. The position also delivers training, workflow optimization, and performance monitoring to drive consistency and operational excellence across the region.
Essential Functions
Education
At ScionHealth, we empower our caregivers to do what they do best. We value every voice by caring deeply for every patient and each other. We show courage by running toward the challenge and we lean into new ideas by embracing curiosity and question asking. Together, we create our culture by living our values in our day-to-day interactions with our patients and teammates.
Job Summary
The Regional Coordinator – Physician Revenue Cycle serves as a key liaison between facility-based operations and centralized billing functions, supporting multiple sites to optimize revenue cycle performance. This role focuses on accounts receivable management, denial resolution, charge capture integrity, and charge description master (CDM) maintenance. The Coordinator partners with clinical, operational, and billing stakeholders to standardize processes, improve compliance, reduce revenue leakage, and enhance reimbursement outcomes. The position also delivers training, workflow optimization, and performance monitoring to drive consistency and operational excellence across the region.
Essential Functions
- Acts as a liaison between facilities and centralized billing operations to align revenue cycle processes and performance.
- Manages and analyzes accounts receivable (A/R) across multiple sites, including payer follow-up, appeals, and resolution of outstanding balances.
- Identifies denial trends, conducts root cause analysis, and implements corrective action plans to improve reimbursement and reduce denials.
- Maintains and updates the physician group Charge Description Master (CDM), including new, revised, and deleted charges to ensure accurate coding and billing.
- Audits charges, coding, and patient accounts to ensure compliance with regulatory requirements and prevent revenue leakage.
- Collaborates with clinical departments, billing teams, and IT to ensure accurate charge capture workflows and system alignment.
- Monitors revenue cycle KPIs (e.g., net collection rate, aging days) and prepares performance reports for regional and facility leadership.
- Evaluates registration, insurance verification, and front-end workflows to reduce errors impacting downstream billing and collections.
- Provides training and education to facility and centralized business office staff on coding updates, billing policies, system functionality, and best practices.
- Develops training materials, including user guides, tip sheets, and workflow documentation.
- Supports system implementations, upgrades, and operational changes through on-site or virtual training and troubleshooting.
- Observes workflows and identifies process improvement opportunities to enhance system utilization and operational efficiency.
- Ensures compliance with HIPAA, federal/state regulations, and payer requirements in all revenue cycle activities.
- Supports productivity monitoring and collaborates with leadership to achieve performance standards.
- Assists leadership with special projects, pilot programs, and operational initiatives.
- Provides backup support for leadership functions, including payroll-related activities, as needed.
- Comprehensive knowledge of physician revenue cycle operations, including billing, coding (ICD-10, CPT), and reimbursement methodologies
- Strong understanding of charge capture, CDM maintenance, and regulatory compliance requirements
- Ability to analyze data, identify trends, and implement process improvements
- Proficiency in Microsoft Office Suite, particularly Excel
- Strong communication, training, and interpersonal skills
- Ability to work independently and collaboratively in a fast-paced, multi-site environment
- Strong problem-solving skills and attention to detail
- Knowledge of Rural Health Clinic (RHC) and provider-based billing preferred
- Understanding of payer rules, claims processing, and denial management
Education
- Associate’s Degree in Healthcare Administration, Business, Finance, or related field (Required)
- Bachelor’s Degree in related field (Preferred)
- CCS-Certified Coding Specialist or CPC or equivalent (Required)
- 5 years progressive experience in healthcare revenue cycle operations (Required) And
- Prior Experience in a leadership or supervisory role (Preferred) And
- Prior Experience with physician billing, charge master management, and payer reimbursement methodologies (Required) And
- Prior Experience with EMR/RCM systems (e.g., Athena) (Preferred)