Denials Management Consultant

The Wilshire Group; Los Angeles (CA); Remote; USD 80,000 - 100,000; Full time

Job summary

The Wilshire Group seeks a Denials Management Consultant to optimize revenue cycles at a prominent healthcare facility. This remote contract role emphasizes denial management and prevention strategies, providing a dynamic opportunity to thrive in a fast-paced environment alongside skilled professionals in healthcare consulting.

Qualifications

• 3-5 years experience in hospital-based denial management.
• Strong proficiency in Epic systems required.
• In-depth knowledge of denial codes and payer policies.

Responsibilities

• Analyze denial trends using Epic work queues.
• Collaborate with teams to develop denial prevention strategies.
• Train stakeholders on best practices in denial management.

Skills

Analytical Skills

Communication Skills

Problem-Solving Skills

Education

Bachelor's degree in Healthcare Administration

Tools

Epic Systems

Job description

Join to apply for the Denials Management Consultant role at The Wilshire Group

2 weeks ago Be among the first 25 applicants

Join to apply for the Denials Management Consultant role at The Wilshire Group

Wilshire hires only the brightest and most experienced professionals in the healthcare revenue cycle management industry. Wilshire will take the time to get know you and your employment history. We will then place you in a role that will lead to a path of career success.



About The Wilshire Group

The Wilshire Group, a renowned boutique consulting firm in Los Angeles, specializes in revenue cycle optimization and fostering effective collaboration between operational and IT facets. With a robust track record of aiding over 100 healthcare systems nationwide, our team thrives on professionalism, efficiency, and adaptability.

Our core values- professionalism, efficiency, and flexibility- underscore our commitment to creating an inclusive and dynamic workplace. We embrace diverse narratives and believe in offering opportunities to exceptional individuals who bring their best to the table.

We are currently offering a contracted interim position at one of US News Best Hospitals 2022-23. This position caters to top performers seeking a professional environment that acknowledges and values their dedication and proficiency. While this role doesn't offer benefits, it presents an opportunity to work within an organization that encourages talented individuals to surpass conventional boundaries.

Join us at The Wilshire Group, a place where talented professionals find a home to showcase their skills and contribute meaningfully to the healthcare landscape.

Why Wilshire? Employee Testimonial

"The number of RCM subject matter experts I get to work with each day is unreal. Working alongside and as part of this team to help shape the RCM space is exciting."-Patti Consolver, Director of Business Development

Job Title: Denial Management Consultant (Epic | Remote | Contract)

Contract Length: 6 Months

Compensation: $90–$108 per hour

Location: Remote (U.S.-based)

About the Role:

We are seeking a highly skilled Denial Management Consultant with hands-on experience in Epic to support revenue cycle optimization efforts, with a focus on denial prevention, management, and resolution. This is a contract position ideal for someone who thrives in a fast-paced, hospital-based environment and is comfortable working independently.

Key Responsibilities:

• Analyze denial trends and root causes using Epic work queues, dashboards, and reporting tools.
• Collaborate with billing, coding, and clinical teams to develop and implement denial prevention strategies.
• Optimize existing denial workflows and recommend system and operational improvements.
• Monitor key performance indicators (KPIs) related to denials and accounts receivable.
• Train internal stakeholders on best practices in denial management and Epic functionality.
• Provide weekly progress updates and contribute to overall revenue cycle optimization goals.
  
  

Required Qualifications:

• 3–5 years of experience in hospital-based denial management and revenue cycle optimization.
• Strong proficiency in Epic systems (Prelud and Cadence, certification or proven experience required).
• In-depth knowledge of denial codes, payer policies, and appeals processes.
• Bachelor's degree required (Healthcare Administration, Business, or related field).
• Experience in a patient/hospital setting is strongly preferred.
• Exceptional analytical, communication, and problem-solving skills.
  
  

Preferred Skills:

• Epic certifications in HB or PB claims, hospital billing, or denial workflows.
• Background in performance improvement, healthcare consulting, or health system operations.
• Familiarity with CMS and commercial payer rules.
  
  

Work Environment:

• 100% remote
• Flexible scheduling with expectations for regular communication and status reporting
• Collaborative virtual team environment
  
  

Wilshire is honored that you have taken the time to review/apply to our open position. We will now take the time to review your experience and be in touch with you soon.

Seniority level

• Seniority level

  Mid-Senior level

Employment type

• Employment type

  Contract

Job function

• Job function

  Consulting, Information Technology, and Sales

• Industries

  Hospitals and Health Care

Referrals increase your chances of interviewing at The Wilshire Group by 2x

Get notified about new Management Consultant jobs in Los Angeles, CA.

Chief of Staff & Strategic Advisor to Senior Vice President - Government Programs (Medicare/Medicaid Strategy)

Pasadena, CA $140,000.00-$194,000.00 1 month ago

Chief of Staff & Strategic Advisor to Senior Vice President - Government Programs (Medicare/Medicaid Strategy)

Los Angeles, CA $140,000.00-$194,000.00 1 month ago

Automotive Repair Risk Management Consultant (Part-Time)

Senior Scheduling Consultant (Mountain Time Zone or Pacific Time Zone)

Pasadena, CA $137,000.00-$178,000.00 6 months ago

Business Development Consultant - Satellite Propulsion

Los Angeles, CA $100.00-$250.00 4 hours ago

Consulting Business Development Consultant - Satellite Propulsion

Santa Monica, CA $100.00-$250.00 3 days ago

Director Industry Consulting - Life Sciences

Cypress, CA $219,120.00-$328,680.00 6 days ago

Senior Growth Consultant, Coldwell Banker (California Based Remote)

Digital Forensic Consultant - California, USA (key requirement) - $80,000 to $100,000

NetSuite Functional Consultant – Manager

Business Tax Consultant - Work From Home

Los Angeles, CA $150,000.00-$200,000.00 13 hours ago

Senior Advisor, Civil & Environmental Engineering

Cardiovascular-Renal Sales Consultant - Pasadena, CA

Long Beach, CA $112,200.00-$137,200.00 1 week ago

Specialty Sales Consultant - Santa Barbara Territory (Remote)

Pasadena, CA $116,800.00-$175,200.00 2 weeks ago

Consulting Clinical Info Systems Analyst

Oracle Data & Analytics Functional Consultant - Senior Associate

Specialty Sales Consultant - Santa Barbara Territory (Remote)

Pasadena, CA $116,800.00-$175,200.00 53 minutes ago

Business Tax Consultant - Work From Home

We’re unlocking community knowledge in a new way. Experts add insights directly into each article, started with the help of AI.