Remote Revenue Integrity Consultant - Epic/CDM Expert

The Wilshire Group; Houston (TX); Remote; USD 171,924,000 - 186,252,000; Full time

Job summary

The Wilshire Group is seeking an experienced Revenue Integrity Consultant to join our team and support client engagements focused on revenue integrity, charging, compliance, and optimization.

This role is primarily remote with periodic travel to Houston, TX as needed, and requires strong hospital revenue cycle expertise, proficiency with Epic HB and PB, and the ability to identify opportunities that improve financial performance and revenue integrity.

Qualifications

• 10+ years of revenue integrity experience in a hospital or health system.
• Strong knowledge of Epic HB and PB, focused on charging and capture.
• Expertise in chargemaster management and revenue integrity operations.

Responsibilities

• Partner with client teams to assess current revenue integrity processes and identify opportunities for improvement.
• Provide comprehensive Chargemaster (CDM) expertise across Hospital Billing (HB) and Professional Billing (PB). CDM Consolidation experience for a new install or an Epic Refuel is a requirement for this role.
• Review CDM structure, maintenance, and processes to identify revenue leakage, charging issues, and opportunities for improved charge capture.
• Evaluate and align revenue codes with appropriate hard-coded and soft-coded charging requirements.
• Analyze charging workflows and provide strategic recommendations to improve revenue integrity and compliance.
• Identify and support optimization opportunities related to CDM management, maintenance, and integration with clinical and financial Epic modules.
• Apply revenue integrity best practices to support charge capture, billing accuracy, and denial prevention.
• Review revenue cycle processes for compliance with hospital billing requirements and identify potential audit risks.
• Support revenue integrity assessments, implementations, optimization projects, and post-live stabilization activities.
• Collaborate with operational, clinical, financial, and IT stakeholders to develop practical solutions.
• Communicate findings, recommendations, and project status clearly to client leadership and project teams.
• Adapt to varying client needs and provide support across multiple areas of a project when needed.
• Contribute to the continued growth and success of The Wilshire Group through knowledge sharing, collaboration, and professional development.

Skills

Revenue integrity

Epic HB

Epic PB

Chargemaster management

Revenue leakage

Education

Bachelor's degree or equivalent

Tools

Epic certification

Job description

The Wilshire Group is seeking an experienced Revenue Integrity Consultant to join our team and support client engagements focused on revenue integrity, charging, compliance, and optimization.

This role is primarily remote with periodic travel to Houston, TX as needed, and requires strong hospital revenue cycle expertise, proficiency with Epic HB and PB, and the ability to identify opportunities that improve financial performance and revenue integrity.