Healthcare Finance & Compliance Consultant

Healthcare Finance & Compliance Consultant

We are seeking an experienced Healthcare Finance & Compliance Consultant to support financial operations, risk management, and regulatory compliance within a healthcare environment. This role will focus on documenting financial workflows, managing revenue cycle processes, and developing downtime procedures to ensure operational continuity.

The ideal candidate will possess deep expertise in healthcare finance, reimbursement policies, and regulatory requirements such as Medicare, Medicaid, Stark Law, and the Anti-Kickback Statute. This individual will collaborate with cross-functional teams to strengthen financial controls, mitigate risks, and ensure compliance with industry standards. Additionally, the consultant will play a key role in training stakeholders on financial best practices and downtime preparedness to maintain seamless operations.

Key Responsibilities

• Provide consulting services to ensure compliance with Medicare, Medicaid, Stark Law, Anti-Kickback Statute, and other healthcare financial regulations.

• Assess financial risks, identify billing inefficiencies, and address compliance gaps by recommending process improvements.

• Document financial workflows, revenue cycle procedures, and standard operating procedures (SOPs).

• Develop and implement downtime procedures for financial systems to ensure uninterrupted operations.

• Collaborate with finance, compliance, legal, and clinical operations teams to enhance financial reporting, billing accuracy, and internal controls.

• Monitor changes in healthcare finance regulations and reimbursement policies; identify emerging financial risks.

• Assist in internal audits, risk assessments, and financial compliance reviews.

• Provide training and support on financial compliance protocols, revenue cycle optimization, and downtime response strategies.

Qualifications

• Minimum of 5 years of experience in healthcare finance, revenue cycle management, or financial compliance.

• Strong knowledge of healthcare billing, reimbursement methodologies, and regulatory frameworks.

• Proven experience in documenting financial workflows and developing SOPs.

• Familiarity with implementing downtime procedures for financial operations.

• Ability to analyze complex financial and compliance issues and deliver actionable insights.

• Excellent communication, training, and stakeholder engagement skills.