Business Process Consultant - Hospital Billing

Gestão Smart Serviços Contábeis; United States; Remote; USD 118,000 - 150,000; Full time

Benefits offered by this job

Medical Insurance

Dental Insurance

Vision Insurance

HSA

FSA

401(k) match

Paid Time Off

Wellness Stipend

Job summary

Chartis is seeking a Business Process Consultant (BPC) with 5+ years of Epic revenue cycle leadership experience and active Epic HB Claims certifications to join our Revenue Cycle Transformation Practice in the United States. The role designs and implements solutions to improve end-to-end claims management for clients using Epic HB Claims workflows.

You will lead assessments of current processes, design future-state workflows, reduce denials, improve clean claim rates, accelerate cash flow, and

Qualifications

• 5+ years of revenue cycle leadership or consulting experience.
• Active Epic HB Claims certification required.
• Deep understanding of end-to-end revenue cycle processes, including charge capture, coding, claim edits, denial management, and A/R follow-up.
• Strong knowledge of payer rules, CMS guidelines, and regulatory requirements.

Responsibilities

• Workflow Analysis and Design: Evaluate current-state professional and hospital billing claims workflows, including charge review, claim edits, claim submission, denial management, and follow-up processes. Identify root causes of denials, compliance risks, and operational inefficiencies. Design future-state workflows aligned with Epic best practices and organizational policies.
• System Configuration and Build: Advise IT and application teams on best practices for configuring HB Claims modules, including claim edits, workqueues, routing rules, scrubbers, remittance processing, and denial workflows. When appropriate, complete in-system configuration and build to support optimized claims performance.
• Claims Performance Optimization: Analyze key revenue cycle metrics such as clean claim rate, denial rate, DNFB/DNFC, A/R days, cash acceleration, and write-offs. Develop action plans to improve claims accuracy, timeliness, and reimbursement outcomes. Leverage Epic reporting tools (Clarity, Caboodle, Reporting Workbench) to drive insights and sustainable improvements.
• Denial Prevention and Resolution Strategy: Design and implement denial prevention frameworks, including front-end and mid-cycle controls that reduce downstream claim rework. Standardize denial categorization and trending methodologies to improve root cause analysis and accountability.
• Stakeholder Collaboration: Partner closely with billing operations, coding, CDI, compliance, managed care, and IT teams. Serve as a liaison between operational and technical stakeholders by translating business needs into effective Epic system solutions.
• Optimization and Reporting: Develop and/or monitor key performance indicators (KPIs). Recommend ongoing improvements and system tweaks. Build and/or guide patient experience reporting efforts using Clarity, Caboodle, Reporting Workbench, etc.
• Testing and Validation: Guide and support testing efforts (unit, integrated, user acceptance testing, etc.). Validate new features and configurations through structured testing plans.

Skills

Revenue cycle leadership

Stakeholder collaboration

Project management

Analytical mindset

Tools

Epic HB Claims

Clarity

Caboodle

Reporting Workbench

Job description

About Chartis

The challenges facing US healthcare are longstanding and all too familiar. We are Chartis, and we believe in better. We work with more than 1,900 organizations annually to develop and activate transformative strategies, operating models, and organizational enterprises that make US healthcare more affordable, accessible, safe, and human. With more than 1,450 professionals, we help providers, payers, technology innovators, retail companies, and investors create and embrace solutions that tangibly and materially reshape healthcare for the better. Our family of brands—Chartis, Jarrard, Greeley, and HealthScape Advisors—is 100% focused on healthcare and each has a longstanding commitment to helping transform healthcare in big and small ways. Believe in better.

About Chartis

The challenges facing US healthcare are longstanding and all too familiar. We are Chartis, and we believe in better. We work with more than 1,900 organizations annually to develop and activate transformative strategies, operating models, and organizational enterprises that make US healthcare more affordable, accessible, safe, and human. With more than 1,450 professionals, we help providers, payers, technology innovators, retail companies, and investors create and embrace solutions that tangibly and materially reshape healthcare for the better. Our family of brands—Chartis, Jarrard, Greeley, and HealthScape Advisors—is 100% focused on healthcare and each has a longstanding commitment to helping transform healthcare in big and small ways. Believe in better.

Chartis has offices in Boston, Chicago, New York, Washington D.C., and Nashville.

Remote work is allowed.

Role Overview

Business Process Consultant, Epic HB Claims

Chartis is seeking a Business Process Consultant (BPC) with 5+ years of Epic revenue cycle leadership experience and active Epic certifications in Hospital Billing (HB) Claims to join our Revenue Cycle Transformation Practice.

As a BPC, you will design and implement solutions aimed at improving end-to-end claims management performance for our clients. You will primarily work with organizations using Epic’s HER and revenue cycle applications, advising on and optimizing Epic HB Claims workflows.

You will lead efforts to assess current claims processes, design future-state workflows, reduce denials, improve clean claim rates, accelerate cash flow, and enhance compliance. The role requires close collaboration with executive leadership, revenue cycle operations, IT, and cross-functional teams to align claims strategies with broader financial and organizational goals.

Responsibilities

• Workflow Analysis and Design: Evaluate current-state professional and hospital billing claims workflows, including charge review, claim edits, claim submission, denial management, and follow-up processes. Identify root causes of denials, compliance risks, and operational inefficiencies. Design future-state workflows aligned with Epic best practices and organizational policies.
• System Configuration and Build: Advise IT and application teams on best practices for configuring HB Claims modules, including claim edits, workqueues, routing rules, scrubbers, remittance processing, and denial workflows. When appropriate, complete in-system configuration and build to support optimized claims performance.
• Claims Performance Optimization: Analyze key revenue cycle metrics such as clean claim rate, denial rate, DNFB/DNFC, A/R days, cash acceleration, and write-offs. Develop action plans to improve claims accuracy, timeliness, and reimbursement outcomes. Leverage Epic reporting tools (Clarity, Caboodle, Reporting Workbench) to drive insights and sustainable improvements.
• Denial Prevention and Resolution Strategy: Design and implement denial prevention frameworks, including front-end and mid-cycle controls that reduce downstream claim rework. Standardize denial categorization and trending methodologies to improve root cause analysis and accountability.
• Stakeholder Collaboration: Partner closely with billing operations, coding, CDI, compliance, managed care, and IT teams. Serve as a liaison between operational and technical stakeholders by translating business needs into effective Epic system solutions.
• Optimization and Reporting: Develop and/or monitor key performance indicators (KPIs). Recommend ongoing improvements and system tweaks. Build and/or guide patient experience reporting efforts using Clarity, Caboodle, Reporting Workbench, etc.
• Testing and Validation: Guide and support testing efforts (unit, integrated, user acceptance testing, etc.). Validate new features and configurations through structured testing plans.

Qualifications And Desired Skills

• 5+ years of revenue cycle leadership or consulting experience, with deep expertise in claims management. Both technical and operational experience is required.
• Active Epic certification in Hospital Billing (HB) Claims required. Additional Epic Revenue Cycle certifications (e.g., Resolute PB/HB, Charge Router, Remittance, Claim Edit, etc.) preferred.
• In-depth understanding of end-to-end revenue cycle processes, including charge capture, coding, claim edits, claim submission, denial management, and A/R follow-up.
• Strong knowledge of payer rules, CMS guidelines, and regulatory requirements impacting claims and reimbursement.
• Demonstrated success improving KPIs such as clean claim rate, denial rate, and A/R performance.
• Experience leveraging Epic reporting tools (Clarity, Caboodle, Reporting Workbench) for operational insights.
• Ability to bridge technical configuration with operational strategy.
• Demonstrated ability to clearly communicate with all levels of an organization, both verbally and in writing.
• Strong project management and communication skills.

Salary range: $118,000-$150,000, plus may be eligible for an annual discretionary bonus. The salary range for this role takes into account the wide range of factors that are considered in making compensation decisions including, but not limited to, skills, experience, training, licensure and certifications, practice area, and other business and organizational needs. In addition, Chartis offers several benefits including medical, dental, vision, HSA, FSA, disability insurance, life insurance, 401(k) match, paid time off, wellness stipend, and additional voluntary benefits.

At Chartis, we pride ourselves on having a diverse workforce. We value and celebrate the uniqueness of individuals and the different perspectives they provide. We offer equal opportunity employment regardless of race, color, religion, gender identity or expression, sexual orientation, national origin, genetics, disability status, age, marital status, or protected veteran status.