Revenue Cycle Optimization

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 

This is a contracted position for 12+ months.  This positions offers 60% of fee sharing.  Equivalent to $85-$100 per hour.

Job Summary

Position Summary

The Wilshire Group is seeking an experienced Optimization Specialist to lead initiatives that enhance the effectiveness and efficiency of Financial Clearance workflows and operations. This role requires deep expertise in Financial Clearance Work Queue (WQ) rules and optimization strategies, combined with hands-on experience in call center and registration processes from an operational and improvement perspective. The successful candidate will work collaboratively across departments to develop, implement, and refine solutions that improve patient access, streamline revenue cycle processes, and elevate the overall patient and staff experience.

Key Responsibilities

1. Financial Clearance Optimization:

• Analyze, design, and optimize Financial Clearance Work Queue (WQ) rules to maximize performance, compliance, and operational efficiency.
• Identify opportunities to automate and streamline financial clearance workflows, including eligibility verification, authorization management, and denial prevention.
• Monitor and analyze WQ metrics, reporting trends and developing actionable insights to improve outcomes.

2. Call Center Operations:

• Evaluate current call center workflows and identify areas for optimization to improve responsiveness, patient experience, and first-call resolution rates.
• Develop and implement strategies to reduce patient wait times and enhance the efficiency of scheduling and registration processes.
• Collaborate with IT and operations teams to integrate optimization tools and systems into call center operations.

3. Registration Process Improvement:

• Assess front-end registration workflows and recommend process improvements to increase accuracy and efficiency.
• Partner with training teams to ensure staff understand and adopt new workflows or system updates.
• Identify opportunities to reduce errors, delays, and redundancies in patient registration processes.

4. Cross-Departmental Collaboration:

• Partner with clinical and administrative teams to ensure revenue cycle goals align with organizational priorities and patient care objectives.
• Act as a liaison between IT, operations, and revenue cycle teams to implement optimization projects.
• Provide expertise and consultation during the design and implementation of new systems, tools, and workflows related to financial clearance, call center, and registration operations.

5. Reporting and Performance Analysis:

• Regularly report key metrics, including WQ performance, call center efficiency, and registration accuracy.
• Develop dashboards and tools to track and communicate optimization outcomes to stakeholders.
• Utilize data-driven insights to refine and iterate on strategies.

Qualifications

Education:

• Bachelor’s degree in Healthcare Administration, Business Administration, or a related field.
• Master’s degree preferred.

Experience:

• Minimum of 5 years of experience in revenue cycle operations with a focus on financial clearance and workflow optimization.
• Experience in call center and registration operations, with demonstrated success in improving workflows and outcomes.
• Strong operational knowledge of  Epic.

Skills and Competencies:

• Advanced understanding of Financial Clearance Work Queue rules and revenue cycle best practices.
• Proficiency in operational analysis and process improvement methodologies, such as Lean or Six Sigma.
• Excellent project management skills with the ability to prioritize and manage multiple initiatives simultaneously.
• Strong interpersonal and communication skills to collaborate effectively with cross-functional teams.
• Analytical mindset with expertise in data visualization and reporting tools.

Work Environment

• Remote
• 15% travel
• Fast-paced healthcare setting requiring adaptability and collaboration.