RCM Consultant

RCM CONSULTANT.

Job Family

Function

CFO

Job Code

30008798

Reports to Job

Business Unit Lead

Job Description Summary

The Revenue Cycle Management Consultant is responsible for critical activities in the revenue cycle management process .- which includes but is not limited to: revenue cycle operational and strategic planning, optimizing revenue performance and financial compliance, managing projects and system implementations, and providing both technical and operational support to enhance revenue cycle efficiency and accuracy while ensuring regulatory compliance

Strategic Roles & Responsibilities %

40

Strategic Roles & Responsibilities

• Develop and implement strategies to optimize charge capture processes ensuring alignment with best practices and maximizing revenue capture
• Oversee any relevant integration and enhancement of EMR HIS LIS and billing systems to Ensure seamless and efficient charge reconciliation
• Lead initiatives to innovate and refine charge capture tools such as Flowsheets and Smart Forms to enhance automation and accuracy
• Formulate and execute strategies for the ongoing development and management of the Charge Description Master including the strategic addition or deletion of charges
• Design and implement strategic approaches to address and prevent claims denials focusing on root cause analysis and longterm resolution
• Drive continuous process improvement initiatives for charge setup and management to enhance operational efficiency and effectiveness
• Utilize data analytics and insights to inform strategic decisions related to charge capture billing processes and revenue cycle management driving overall operational excellence

Operational Roles & Responsibilities %

60

Operational Roles & Responsibilities

• Evaluate current revenue cycle processes to identify inefficiencies bottlenecks and compliance issues and analyze data for performance and effectiveness
• Create and present actionable recommendations to improve billing coding collections and patient account management
• Oversees implementing process improvements system upgrades and staff training to Ensure effective integration of changes
• Ensure adherence to regulations and industry standards identifying and mitigating risks in billing coding and reimbursement
• Engage regularly with healthcare administrators finance teams and IT departments to understand needs and provide tailored solutions including workshops and training
• Set and track key performance indicators KPIs to measure the success of changes and provide ongoing support to achieve desired results
• Oversee charge Description Master CDM maintenance charge capture processes and clinical code management including handling charge automation and denial resolutions
• Guide and train clinical teams align work with organizational goals and promote professional growth while performing additional duties as assigned

Education

A Master’s degree or relevant Bachelor with specialized certification

Certifications

(Certified Revenue Cycle Representative (CRCR) or Certified Professional Coder (CPC)) is often preferred.

Years of Experience

Minimum 16 years’ experience in revenue cycle management or related field, including significant experience in consulting.

Languages

English:Fully Proficient ; Arabic:Basic

Functional Competencies

• Accounts Receivable
• Billing Investigations
• Billing Statement Preparation

Core Competencies

• Excellence
• Integrity
• Accountability
• Cybersecurity
• Person-Centered Care

Acknowledgement

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.