Revenue Cycle Denials Consultant – Project Management

The Wilshire Group is a boutique healthcare consulting firm specializing in revenue cycle, Epic, and healthcare technology solutions. We work with healthcare organizations to improve financial performance, optimize revenue cycle operations, and successfully navigate complex transformation initiatives.

About the Opportunity

This is a 6-month remote contract opportunity for a seasoned revenue cycle professional who combines hands-on denials expertise with the ability to manage projects, coordinate stakeholders, identify opportunities for improvement, and drive initiatives through completion.

The ideal consultant will understand the full denials lifecycle—from prevention and root-cause analysis through follow-up, appeals, resolution, and reporting—and have the project management skills necessary to lead improvement initiatives across revenue cycle teams.

Key Responsibilities

• Assess current denials processes, workflows, and performance.
• Analyze denial trends and identify root causes, opportunities, and areas of financial risk.
• Develop and implement strategies to reduce preventable denials and improve overall revenue cycle performance.
• Lead denials-related projects and initiatives from planning through implementation.
• Develop project plans, timelines, milestones, deliverables, and status reporting.
• Coordinate activities across revenue cycle teams and other key stakeholders.
• Facilitate project meetings and communicate progress, risks, issues, and opportunities.
• Monitor project deliverables and ensure initiatives remain on track.
• Evaluate denial data and develop actionable recommendations for improvement.
• Partner with operational leaders and revenue cycle stakeholders to implement process improvements.
• Identify opportunities to improve workflows, payer processes, authorization practices, coding, billing, and other upstream factors contributing to denials.
• Support the development and implementation of denial prevention strategies.
• Track key performance indicators and measure the impact of improvement initiatives.
• Assist with developing standard operating procedures, workflows, and process documentation.
• Provide subject matter expertise related to revenue cycle denials and best practices.
• Communicate findings and recommendations effectively to both operational and executive-level stakeholders.

Qualifications

• 7+ years of healthcare revenue cycle experience, with significant experience in denials management.
• Strong knowledge of the end-to-end revenue cycle and denials management process.
• Demonstrated experience identifying denial trends and performing root-cause analysis.
• Experience developing and implementing denial prevention and reduction strategies.
• Project management experience required.
• Demonstrated ability to manage multiple project workstreams, timelines, and deliverables.
• Strong analytical and problem-solving skills.
• Experience working with revenue cycle data, reporting, and performance metrics.
• Strong understanding of payer requirements and denial/appeal processes.
• Excellent written and verbal communication skills.
• Ability to work independently in a consulting environment while effectively collaborating with client teams.
• Strong organizational skills and attention to detail.
• Ability to communicate complex revenue cycle issues and recommendations to executive and operational stakeholders.

Preferred Qualifications

• Experience leading revenue cycle transformation or optimization projects.
• Experience working with large health systems or complex healthcare organizations.
• Experience with Epic or other major EHR/PM systems.
• Formal project management certification such as PMP, CAPM, or equivalent is a plus.
• A Bachelor’s degree in healthcare administration, business, finance, or a related field is preferred.

Why Join The Wilshire Group?

The Wilshire Group offers experienced healthcare professionals the opportunity to apply their expertise to meaningful consulting engagements while working alongside a team that understands the complexity of today’s healthcare environment.

If you are a revenue cycle denials expert who can turn analysis into action and lead a project from strategy through execution, we’d love to hear from you.

Join The Wilshire Group and bring your expertise to the next challenge.