Business Process Consultant - Hospital Billing

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