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Denials Business Process Consultant
Denials Business Process Consultant-October 2024
Philadelphia
Oct 31, 2025
About Denials Business Process Consultant

  Reference #: 1007480SHIFT:Day (United States of America)

  Seeking Breakthrough Makers

  Children's Hospital of Philadelphia (CHOP) offers countless ways to change lives. Our diverse community of more than 20,000 Breakthrough Makers will inspire you to pursue passions, develop expertise, and drive innovation.

  At CHOP, your experience is valued; your voice is heard; and your contributions make a difference for patients and families. Join us as we build on our promise to advance pediatric care-and your career.

  CHOP's Commitment to Diversity, Equity, and Inclusion

  CHOP is committed to building an inclusive culture where employees feel a sense of belonging, connection, and community within their workplace. We are a team dedicated to fostering an environment that allows for all to be their authentic selves. We are focused on attracting, cultivating, and retaining diverse talent who can help us deliver on our mission to be a world leader in the advancement of healthcare for children.

  We strongly encourage all candidates of diverse backgrounds and lived experiences to apply.

  A Brief OverviewThe Revenue Cycle Business Consultant supports revenue cycle processes that span multiple departments, multiple workflows and systems or supports analytic efforts of the revenue cycle through report development, data quality assurance, process mapping and analysis. The position also supports business process improvement efforts including projects to enhance Epic, automation, quality, and efficiency through report writing, analysis, business case development and data validation

  What you will doRevenue Process Support, Workflows and SystemsDevelop and maintain written documentation for processes that exist between departments, systems, external vendors and payers.Act as a high-level business process consultant between operations, performance improvement and IT for needs that cross boundaries. Implement processes and practices that can adapt quickly to changing organization, business, and payer demands. The position does not replace normal relationships between various departments but rather acts as a compliment to existing relationships to enhance and expedite performance improvement activities.Reviews business process, system or other changes that might impact existing workflows and recommends methods to optimize to desired state and improve efficiency. Review system or process architecture in scope of assigned projects.Perform business impact reviews of test plans that span across departments, workflows or systems or to assess impact, efficiency and effectiveness.Create, optimize, and support the implementation of processes that link closely to system workflows. Determine how these workflows will impact existing staffing, how to continuously refresh and monitor these flows and recommend optimal change management processes.Communicate information clearly and create an environment where people can engage in open dialogue and reach effective solutions together to optimize workflow or process.Direct cross-functional teams to resolve complex issues related to automated workflows or other complex processes or lead discussions with the business and operational leaders to analyze reporting needs, configure and model data and develop reports using specialized knowledge of reporting applications and software applications.Data Reporting and AnalysisResponsible for creating and managing the financial and operational reports generated on regular and an ad hoc basis using software applications for report writing and data warehousing; provides consultation and assistance to ensure end users and operational reporting needs are met through report development and design.Primary liaison to various internal and external user groups within CHOP in terms of revenue cycle data reporting and analysis. Assist revenue cycle leadership, management, and staff in analyzing, interpreting, and presenting data and information to var ous parties.Develop and build reporting solutions that monitor and benchmark cost, utilization and other quality and performance indicators; Act as primary support to senior leadership in accessing relevant data necessary to develop strategic and operational business plans, and process improvements.Develop business case analysis to support process optimization and change.Perform troubleshooting, problem solving activities related to business intelligence reporting as necessary. Analyze data and reports to understand business impact, correlations/discrepancies, and to propose changes/alternate solutions. Work closely with the Information Technology teams to resolve issues and perform analysis in a timely manner.Education QualificationsHigh School Diploma / GED RequiredBachelor's Degree PreferredExperience QualificationsAt least five (5) years experience with system design, process workflow design or business/systems consulting. RequiredEPIC experience PreferredRevenue Cycle experience PreferredSkills and AbilitiesStrong analytical and communication skills (Required proficiency)Strong computer skills to include database analysis (Required proficiency)Statistical software experience (Preferred proficiency)Extensive knowledge of workflow and/or system design (Required proficiency)Extensive knowledge of analytical tools, business intelligence tools and statistical packages (Required proficiency)Licenses and CertificationsEPIC certification - EPIC - - PreferredLean Six Sigma Green Belt (LSSGB) - Lean Six Sigma Green Belt - LSSGB - American Society for Quality - - Preferred

  To carry out its mission, CHOP is committed to supporting the health of our patients, families, workforce, and global community. As a condition of employment, CHOP employees who work in patient care buildings or who have patient facing responsibilities must be fully vaccinated against COVID-19 and receive an annual influenza vaccine.

  Employees may request exemptions for valid religious and medical reasons. Start dates may be delayed until candidates are immunized or exemption requests are reviewed.

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  Children's Hospital of Philadelphia is an equal opportunity employer. We do not discriminate on the basis of race, color, gender, gender identity, sexual orientation, age, religion, national or ethnic origin, disability or protected veteran status.

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