Revenue Cycle Consultant I

Summary

Join Tria Federal as a Revenue Cycle Consultant (Staff I) and leverage your 2+ years of experience to provide professional consulting services to our Defense Health Agency (DHA) client. You will play a critical role in supporting our clients' revenue cycle management needs, focusing on accounts receivable management, audit readiness, compliance, and project management. This remote, full-time position requires a Bachelor's degree and the ability to obtain and maintain a Public Trust clearance. Responsibilities include A/R management support, audit readiness and response, compliance management, and project management support. The ideal candidate possesses strong analytical, communication, and problem-solving skills, along with experience in healthcare revenue cycle management. Tria offers a top-tier benefits package to invest in your well-being.

Requirements

• Knowledge and a working understanding of revenue cycle concepts, business processes, and/or operations within the healthcare industry (commercial or federal)
• Ability to apply principles and practices in revenue cycle management, such as charge capture, coding, billing, reimbursement, denial management, A/R management, and compliance
• Experience with A/R management, including analysis, process improvement, and standardization
• Experience with audit readiness processes, including the preparation of audit materials, development of audit responses, and implementation of corrective action plans
• Experience with compliance management, including policy development, monitoring, and risk assessment
• Ability to analyze and interpret complex data, processes, and reports related revenue cycle, including A/R data, audit findings, and compliance reports
• Ability to identify and resolve issues and problems related to revenue cycle, specifically with A/R, audit response, and compliance management
• Ability to use various software applications and tools to perform revenue cycle management functions, such as: Electronic Health Record systems (e.g., Oracle/Cerner MHS GENESIS Cerner Patient Accounting (CPA) RevenueCycle)
• Billing/Claim systems (e.g., Electronic Claims Clearinghouse (SSI), 3M 360 Encompass Institutional & Professional Coding, Claim Scrubber Edits (Alpha ii), Dentrix Billing, Patient Statements/Letters (RevSpring))
• Data analytics and reporting (e.g., Excel, Power BI, SAS, Tableau, HealtheAnalytics)
• Ability to succeed in a dynamic team environment and produce deliverables in tight timeframes
• Detail-oriented with commitment to accuracy and quality
• Excellent oral, written, and interpersonal skills
• Ability to collaborate and communicate effectively with team members, clients, business partners, and other various stakeholders
• Proficiency in Microsoft Office Suite (Excel, Word, PowerPoint)
• Bachelor’s degree required, Finance, Business Administration, Healthcare Administration or related field preferred. Masters in Business Administration or related field, ideal
• Ability to Obtain and Maintain a Public Trust
• 2-5 or more years of consulting or healthcare experience required, preferably in a federal consulting environment

Responsibilities

• Assist in the analysis and reconciliation of A/R data to identify trends, patterns, and potential areas for improvement
• Support the development and implementation of A/R management strategies and best practices
• Participate in process discussions to highlight areas for improvement and standardization
• Contribute to the development of reports and presentations summarizing A/R performance
• Participate in client meetings to discuss A/R findings and recommendations
• Assist with the preparation and organization of materials for internal and external audits related to revenue cycle
• Support the development of clear, concise, and well-supported audit responses to address findings
• Ensure documentation is accurate, complete and organized in accordance with regulatory guidelines
• Assist with the development and implementation of corrective action plans to address audit findings
• Contribute to the development of audit remediation strategies and track implementation progress
• Support the development implementation of compliance policies and procedures related to revenue cycle activities and internal controls
• Assist in monitoring compliance with relevant regulations (e.g., Federal, Industry, Financial Management Regulation, DHA Guidance)
• Participate in compliance audits and reviews to identify areas of risk and potential non-compliance
• Support the development of training materials and presentations related to compliance
• Assist with tracking and monitoring of compliance issues and resolutions
• Assist in the planning, execution, and monitoring of projects
• Contribute to the development of project plans, timelines, and deliverables
• Track project progress and identify potential risks and issues
• Participate in internal and external team meetings and knowledge sharing activities
• Facilitate communications among project team members, business partners, and client stakeholders
• Prepare project status reports and presentations
• Conduct research and analysis of relevant industry trends, regulations, and best practices
• Maintain a strong understanding of federal healthcare regulations and policies

Preferred Qualifications

• Experience within the Military Health System (MHS) environment and requisite knowledge of revenue cycle operations
• Knowledge of MHS billing and coding policies and regulations
• Experience with the Oracle/Cerner Electronic Health Record (EHR), Patient Accounting Module (CPAM), Health Analytics, ideally in the MHS environment

Benefits

• Top-tier benefits package to invest in your physical, mental, and financial health and wellness
• Opportunities to learn new skills, seize new challenges, and advance your career