Revenue Cycle Management (RCM) Consultant

The role

This consultant will serve as a subject matter expert to evaluate billing accuracy, identify revenue leakage, and improve reimbursement outcomes. You will partner with internal teams and healthcare system clients to audit claims and assess billing and coding practices.

What you will do

• Conduct detailed audits of medical claims, billing records, coding, and supporting clinical documentation.
• Validate CPT, HCPCS, ICD-10-CM codes, modifiers, and payer-specific billing requirements.
• Identify inaccurate coding, missed charges, duplicate billing, and underbilling.
• Verify that claims meet Medicare, Medicaid, and commercial payer requirements.
• Evaluate end-to-end billing workflows including charge capture, claims submission, denials, and payment reconciliation.
• Analyze denied, rejected, and underpaid claims to determine root causes.
• Recommend improvements to increase billing accuracy and reimbursement capture.
• Partner with client revenue cycle and billing teams to investigate and resolve billing discrepancies.
• Provide guidance on CMS regulations, Medicare billing guidelines, and commercial payer requirements.
• Collaborate with Clinical Operations, Product, Technology, and Finance teams to improve billing workflows.

Required qualifications

• 5+ years of hands-on experience in healthcare revenue cycle management, insurance billing, medical coding, claims auditing, or reimbursement consulting.
• In-depth experience with Epic, Oracle Health/Cerner, or other EHR and billing platforms.
• Extensive expertise in Medicare, Medicaid, and commercial insurance billing and reimbursement requirements.
• Advanced knowledge of CPT, HCPCS, ICD-10-CM coding, modifiers, and payer-specific billing rules.
• Proven experience independently auditing medical claims, identifying coding errors, and resolving reimbursement discrepancies.
• Demonstrated ability to identify revenue leakage, reduce denials, and improve billing accuracy and reimbursement outcomes.
• Experience working with healthcare systems, physician groups, medical practices, or healthcare revenue cycle organizations.
• Strong analytical skills to review complex billing data and translate findings into actionable recommendations.
• Ability to work independently, manage consulting deliverables, and communicate effectively with stakeholders and clients.

Benefits

• Comprehensive medical, dental, and vision coverage for employees and dependents at a low cost
• Up to 35 paid days off each year
• 12 vacation days accrued annually
• Up to 9 sick/wellness days
• 12 paid company holidays
• 2 Paid Give-Back Days to volunteer
• HSA and FSA account options
• 401(k) with company match after 6 months of full-time employment
• 100% match on the first 3% contributed, and 50% match on the next 2% contributed

About the company

Jaan Health is a leading AI-based care management company serving healthcare providers. Phamily is the company's core technology platform that transforms chronic disease management with clinically tested AI.