Revenue Cycle Consultant (Staff I)
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AI Summary
Who we are:
Tria Federal delivers digital services and technology solutions that support the health and safety of veterans, service members and civilians. For two decades, federal agencies have relied on Tria companies to advance their critical missions and modernize their systems, so that they can uphold their commitment to the American people. Today, we are pushing the boundaries of possibility through partnerships and investments in artificial intelligence and emerging technologies, developing solutions for the biggest challenges that government will face tomorrow.
We are proud to employ and support military veterans who bring mission-first mindset, technical expertise, and leadership qualities that strengthen our work. Veterans, transitioning service members, and military spouses are strongly encouraged to apply.
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 accounts receivable (A/R) management, audit readiness and response, compliance management, and project management support.
This role is contingent upon the successful award of the contract. Any offer of employment is subject to contract award and funding availability.
Responsibilities:
- Accounts Receivable (A/R) Management Support:
- 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 meets to discuss A/R findings and recommendations.
Audit Readiness and Response:
- 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.
Compliance Management:
- Support the development and 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.
Project Management Support:
- 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.
Skills and Experience:
- 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) Revenue Cycle).
- 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, Health eAnalytics).
- Ability to succeed in a dynamic team environment and produce deliverables in tight timeframes.
- Detail-oriented with a 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).
Desired Skills and Experience:
- Experience within the Military Health System (MHS) environment and requisite knowledge of revenue cycle operations.
- Experience with the Oracle/Cerner Electronic Health Record (EHR), Cerner Patient Accounting (CPA) Revenue Cycle, Health eAnalytics, ideally in the MHS environment.
- Knowledge of MHS billing and coding policies and regulations.
Why Tria?
What defines the Tria brand is more than just our dedication to excellence in our craft; it’s our incredible team of dedicated, talented, and passionate people that make Tria so exceptional. As people powering possible, we are all partners in our team’s shared success.
As a company that cares about people, we seek to cultivate a culture in which all can thrive personally and professionally. We offer a top-tier benefits package to invest in your physical, mental, and financial health and wellness so that you can be your best self - at work and in life. At Tria, we are growth-minded, entrepreneurial in spirit, and committed to fostering a culture of inclusion and opportunity for all. Whatever your background, your role, your department, or stage in your professional journey, here you will have opportunities to learn new skills, seize new challenges, and advance your career as we grow.
California Consumer Privacy Act (CCPA)
We are committed to protecting your privacy. As part of our compliance with the California Consumer Privacy Act (CCPA), we want to inform you about how we collect, use, and protect your personal information during the job application process. For more details, please review https://www.oag.ca.gov/privacy/ccpa.
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