Role Description
Tria Federal is seeking a highly motivated and detail-oriented Revenue Cycle Consultant (Staff I) to join our team. As a Revenue Cycle Consultant, you will provide professional consulting services to assist our Defense Health Agency (DHA) client in managing their operational and revenue cycle operations. This individual will play a critical role in supporting our clients with their revenue cycle management needs, focusing primarily on:
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Accounts receivable (A/R) management
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Audit readiness and response
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Compliance management
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Project management support
Responsibilities
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Accounts Receivable (A/R) Management Support:
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Assist in the analysis and reconciliation of A/R data to identify trends, patterns, and potential areas for improvement.
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Support the development and implementation of A/R management strategies and best practices.
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Participate in process discussions to highlight areas for improvement and standardization.
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Contribute to the development of reports and presentations summarizing A/R performance.
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Participate in client meetings to discuss A/R findings and recommendations.
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Audit Readiness and Response:
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Assist with the preparation and organization of materials for internal and external audits related to revenue cycle.
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Support the development of clear, concise, and well-supported audit responses to address findings.
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Ensure documentation is accurate, complete, and organized in accordance with regulatory guidelines.
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Assist with the development and implementation of corrective action plans to address audit findings.
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Contribute to the development of audit remediation strategies and track implementation progress.
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Compliance Management:
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Support the development and implementation of compliance policies and procedures related to revenue cycle activities and internal controls.
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Assist in monitoring compliance with relevant regulations (e.g. Federal, Industry, Financial Management Regulation, DHA Guidance).
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Participate in compliance audits and reviews to identify areas of risk and potential non-compliance.
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Support the development of training materials and presentations related to compliance.
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Assist with tracking and monitoring of compliance issues and resolutions.
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Project Management Support:
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Assist in the planning, execution, and monitoring of projects.
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Contribute to the development of project plans, timelines, and deliverables.
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Track project progress and identify potential risks and issues.
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Participate in internal and external team meetings and knowledge sharing activities.
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Facilitate communications among project team members, business partners, and client stakeholders.
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Prepare project status reports and presentations.
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Conduct research and analysis of relevant industry trends, regulations, and best practices.
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Maintain a strong understanding of federal healthcare regulations and policies.
Qualifications
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2 to 4 years of experience in healthcare revenue cycle operations, healthcare finance, or healthcare consulting.
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General understanding of the end-to-end revenue cycle, including registration, charge capture, coding, billing, payment posting, denials, and collections.
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Experience pulling and working with healthcare data to find trends or errors and summarize results.
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Experience working in an electronic health record or revenue cycle system.
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Ability to write clear documentation, such as process notes, SOPs, or reports.
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Proficiency in Microsoft Excel (pivot tables, lookups, and basic formulas), plus working proficiency in Word and PowerPoint.
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Strong attention to detail and the ability to manage multiple tasks and deadlines.
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Clear written and verbal communication skills.
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Willingness to learn new systems, federal regulations, and client processes.
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Bachelor's degree in healthcare administration, business, finance, accounting, or a related field.
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U.S. citizenship and the ability to obtain and maintain a Public Trust.
Desired Skills and Experience
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Proficiency with electronic health record and revenue cycle software and systems, such as:
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Electronic Health Record systems (Oracle/Cerner MHS GENESIS Patient Accounting Module CPAM)
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Billing, coding and claim solutions (Electronic Claims Clearinghouse SSI; 3M 360 Encompass Institutional & Professional Coding; Claim-Scrubber Edits Alpha II; Dentrix Billing; Patient Statements/Letters RevSpring)
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Data analytics tools (Excel, Power BI, SAS, Tableau, Qlik Sense) / repositories (Excel, MHS GENESIS, ABACUS, M2, MDR, EAS IV, Health Data Intelligence/HealtheAnalytics)
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Hands-on experience in back-end functions, such as billing, claims follow-up, denials management, payment posting, or collections.
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Experience supporting compliance reviews, audit readiness, or corrective action plans.
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Experience developing training materials or delivering training.
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Experience supporting the MHS, DHA, Veterans Health Administration (VHA), or other federal healthcare organizations.
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Certified Revenue Cycle Representative (CRCR) or a similar revenue cycle certification.
Benefits
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Top-tier benefits package to invest in your physical, mental, and financial health and wellness.
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Opportunities to learn new skills, seize new challenges, and advance your career.