Location: Remote 

Company: Helix Advisory 

Job Summary: 

Helix Advisory is looking for an experienced Epic Optimization Consultant with a focus on revenue cycle management. This position will leverage your expertise in Epic EHR system optimization to streamline financial operations, improve workflows, and enhance the financial performance of healthcare organizations. You will work closely with revenue cycle and IT leadership to ensure the Epic system is being used to its full potential, focusing on areas including billing, claims, and patient access. 

Key Responsibilities: 

• Epic System Strategy: Develop and implement long-term best practices for Epic optimization, working closely with both operations and IT teams. 

• Revenue Cycle Enhancement: Work with revenue cycle leaders to improve workflows, reduce denials, and increase revenue through Epic system optimization. 

• System Build & Support: Perform system build tasks as per change control processes, participate in testing, and ensure system changes meet operational needs. 

• Epic Issues & Requests: Serve as the point person for identifying Epic system issues and managing change requests. 

• Performance Monitoring: Track key performance indicators (KPIs), recommending workflow adjustments and system enhancements for maximum impact. 

• Education & Training: Assist in creating training materials and provide hands-on education to revenue cycle leadership on Epic best practices. 

• New Business Support: Participate in assessments for potential client improvements and contribute to sales discussions about Epic system functionality. 

Focus Areas: 

• Denial reduction 

• DNFB/CFB reduction 

• Charge and coding accuracy 

• Registration and scheduling accuracy 

• Authorization capture 

• Overall productivity improvement 

Qualifications: 

• Epic Certification: Must hold a current certification in one or more Epic modules related to revenue cycle (e.g., HB, PB, Prelude, Cadence, HIM, Eligibility). 

• Experience: Minimum of 3+ years of experience in Epic system build, implementation, and optimization within revenue cycle operations (billing and patient access areas preferred). 

• Education: Bachelor’s degree in Healthcare, IT, Business, or a related field (or equivalent experience). 

• Skills: Strong knowledge of hospital and/or ambulatory revenue cycle processes. Ability to work with Epic-related interfaces and messaging systems. 

• Travel: Willingness to travel up to 25%. 

Location: Remote 

Department: Revenue Cycle Management/HIM 

Job Type: Contract or Full-time 

Position Summary: 

The Inpatient Medical Coder is responsible for accurately coding diagnoses and procedures for inpatient medical records using ICD-10-CM and ICD-10-PCS coding systems. This role requires a comprehensive understanding of coding guidelines, medical terminology, and hospital reimbursement methodologies. The ideal candidate will have exceptional attention to detail, strong analytical skills, and a commitment to maintaining the highest coding standards. 

Key Responsibilities: 

• Medical Record Review: 

• Analyze inpatient medical records to identify all relevant diagnoses and procedures. 

• Ensure documentation supports coding accuracy and completeness. 

• Accurate Coding: 

• Assign appropriate ICD-10-CM and ICD-10-PCS codes for inpatient admissions in compliance with official coding guidelines. 

• Validate coded data to ensure it aligns with clinical documentation and payer requirements. 

• Compliance and Quality Assurance: 

• Ensure coding practices comply with federal and state regulations, payer policies, and organizational standards. 

• Participate in coding audits and quality assurance activities to maintain coding accuracy and compliance. 

• Collaboration and Communication: 

• Work closely with healthcare providers, clinical documentation specialists, and billing staff to resolve coding discrepancies and improve documentation practices. 

• Provide feedback and education to clinical staff on coding-related issues and documentation improvement. 

• Continuing Education: 

• Stay updated on changes in coding standards, payer guidelines, and healthcare regulations. 

• Participate in ongoing training and development opportunities to enhance coding skills and knowledge. 

Qualifications: 

• Education: 

• High school diploma or equivalent required. 

• Associate’s degree in Health Information Management or related field preferred. 

• Experience: 

• Minimum of 2 years of experience in inpatient medical coding. 

• Experience in a hospital revenue cycle or billing department is a plus. 

• Skills: 

• Proficiency in ICD-10-CM and ICD-10-PCS coding systems. 

• Strong analytical skills with attention to detail and accuracy. 

• Excellent communication and interpersonal skills. 

• Ability to work independently and as part of a team. 

• Proficiency in using coding software and electronic health record systems. 

• Certifications: 

• Certified Coding Specialist (CCS) certification required. 

• Additional certifications in inpatient coding are a plus. 

Location: Remote 

Department: Revenue Cycle Management 

Job Type: Contract or Full-time 

Company Overview: 

Helix Advisory is a leading healthcare consulting firm specializing in revenue cycle management and optimization. We work with healthcare organizations to enhance their financial performance by identifying underpayments, optimizing clinical documentation, and managing appeals processes. Our team is dedicated to delivering exceptional results and driving innovation in healthcare finance. 

Position Summary: 

The Clinical Appeals Nurse is responsible for reviewing denied claims, preparing clinical appeal letters, and collaborating with payers to overturn denials. This role requires a strong understanding of clinical guidelines, payer policies, and healthcare regulations. The ideal candidate will have excellent analytical and communication skills, a keen eye for detail, and a passion for advocating on behalf of patients and providers. 

Key Responsibilities: 

• Denial Review and Analysis: 

• Review medical records and denial reasons to determine the validity of the denial. 

• Analyze clinical documentation to ensure it supports the services billed and meets payer requirements. 

• Appeal Preparation and Submission: 

• Prepare detailed and persuasive appeal letters to address clinical denials. 

• Submit appeals to payers, ensuring compliance with payer guidelines and timelines. 

• Collaboration and Communication: 

• Work closely with healthcare providers, billing staff, and coding specialists to gather necessary documentation and insights. 

• Communicate effectively with payers to clarify clinical information and advocate for claim approval. 

• Education and Training: 

• Provide education and feedback to clinical staff on documentation improvement and denial prevention. 

• Stay updated on industry trends, payer policy changes, and regulatory updates to ensure best practices in appeals management. 

• Data Tracking and Reporting: 

• Maintain accurate records of appeal activities, outcomes, and payer responses. 

• Generate reports on denial trends, appeal success rates, and areas for improvement. 

Qualifications: 

• Education: 

• Registered Nurse (RN) with an active nursing license. 

• Bachelor’s degree in Nursing or related field preferred. 

• Experience: 

• Minimum of 2 years of experience in clinical appeals, utilization review, case management, or a related field. 

• Experience in a healthcare revenue cycle or billing department is a plus. 

• Skills: 

• Strong clinical knowledge and the ability to interpret medical records and coding documentation. 

• Excellent written and verbal communication skills, with the ability to articulate clinical concepts clearly. 

• Detail-oriented with strong organizational and time management abilities. 

• Proficiency in Microsoft Office Suite (Word, Excel, Outlook) and electronic health record systems. 

• Certifications: 

• Certified Clinical Documentation Specialist (CCDS) or similar certification is a plus. 

Why Join Helix Advisory? 

• Impactful Work: Play a crucial role in ensuring patients receive the care they need and healthcare providers are fairly reimbursed. 

• Professional Development: Opportunities for growth and advancement in a dynamic and supportive environment. 

• Collaborative Team: Work with a talented team of professionals committed to excellence and innovation. 

• Competitive Compensation: Attractive salary and benefits package, including health insurance and retirement plans. 

Location: Remote 

Department: Revenue Cycle Management 

Job Type: Contract or Full-time 

Company Overview: 

Helix Advisory is a leading healthcare consulting firm specializing in revenue cycle management and optimization. We are committed to helping healthcare organizations enhance their clinical documentation practices, improve patient outcomes, and maximize financial performance. Our team of experts provides innovative solutions and exceptional service to our clients, driving excellence in healthcare delivery. 

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Position Summary: 

The Clinical Documentation Improvement (CDI) Specialist is responsible for improving the accuracy, completeness, and quality of clinical documentation in patient medical records. This role involves collaborating with healthcare providers to ensure documentation reflects the complexity of care provided and supports appropriate reimbursement. The ideal candidate will have a strong clinical background, excellent communication skills, and a deep understanding of coding and documentation requirements. 

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Key Responsibilities: 

• Documentation Review and Analysis: 

• Conduct thorough reviews of patient medical records to identify opportunities for documentation improvement. 

• Ensure clinical documentation accurately reflects the patient’s clinical status, care provided, and severity of illness. 

• Provider Collaboration and Education: 

• Collaborate with physicians and clinical staff to clarify documentation and improve the accuracy of medical records. 

• Provide education and feedback to providers on best practices for clinical documentation. 

• Coding and Compliance Support: 

• Work closely with coding and billing teams to ensure documentation supports accurate coding and reimbursement. 

• Assist in resolving discrepancies between clinical documentation and coded data. 

• Data Analysis and Reporting: 

• Analyze data and metrics related to clinical documentation and identify trends or areas for improvement. 

• Prepare reports on CDI program outcomes and present findings to leadership. 

• Program Development and Implementation: 

• Develop and implement CDI initiatives to enhance documentation practices and support organizational goals. 

• Stay updated on industry trends, regulatory changes, and best practices in clinical documentation improvement. 

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Qualifications: 

• Education: 

• Registered Nurse (RN) or other clinical background required. 

• Bachelor’s degree in Nursing, Health Information Management, or related field preferred. 

• Experience: 

• Minimum of 3 years of experience in clinical documentation improvement, utilization review, or related field. 

• Experience in a healthcare revenue cycle or coding department is a plus. 

• Skills: 

• Strong clinical knowledge and understanding of medical terminology and coding systems (ICD-10, CPT, DRG). 

• Excellent communication and interpersonal skills, with the ability to work effectively with providers and staff. 

• Analytical skills with attention to detail and accuracy. 

• Proficiency in using electronic health records and CDI software. 

• Certifications: 

• Certified Clinical Documentation Specialist (CCDS) or Certified Documentation Improvement Practitioner (CDIP) certification required.