Remote RCM Consultant: Claims Audit & Denials Expert

Phamily; Columbus (OH); Remote; USD 96,000 - 179,000; Part time

Job summary

Phamily is seeking an experienced Revenue Cycle Management consultant to partner with healthcare system clients and evaluate billing accuracy, identify revenue leakage, and improve reimbursement outcomes.

The role requires hands-on auditing of claims, CPT/HCPCS/ICD-10-CM coding, and expertise with major EHR/billing platforms. You will independently audit and provide actionable recommendations while traveling up to 20% to client sites.

Qualifications

• 5+ years hands-on experience in healthcare revenue cycle management.
• Deep expertise in insurance billing, medical coding, claims auditing, and reimbursement optimization.
• Experience with Epic, Oracle Health/Cerner or other EHR/billing platforms.
• Advanced knowledge of CPT, HCPCS, ICD-10-CM coding, modifiers, and payer-specific billing rules.
• Proven ability to audit medical claims, identify discrepancies, and recommend corrective actions.

Responsibilities

• Conduct detailed audits of medical claims, billing records, coding, and documentation.
• Evaluate end-to-end billing workflows, including charge capture, claims submission, denials, and payment reconciliation.
• Present findings and actionable recommendations to improve accuracy, compliance, and reimbursement outcomes.
• Develop standardized claims audit procedures and billing best practices; collaborate with cross-functional teams.

Skills

Revenue cycle

Claims auditing

Billing accuracy

Reimbursement optimization

Analytics

Independent consulting

Tools

Epic

Oracle Health

Cerner

Job description

Phamily is seeking an experienced Revenue Cycle Management consultant to partner with healthcare system clients and evaluate billing accuracy, identify revenue leakage, and improve reimbursement outcomes.

The role requires hands-on auditing of claims, CPT/HCPCS/ICD-10-CM coding, and expertise with major EHR/billing platforms. You will independently audit and provide actionable recommendations while traveling up to 20% to client sites.