Revenue Cycle Consultant (Staff Consultant I)

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.

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.

Required Skills and Experience

2 to 4 years of experience in healthcare revenue cycle operations, healthcare finance, or healthcare consulting.

General understanding of the end-to-end revenue cycle, including registration, charge capture, coding, billing, payment posting, denials, and collections.

Experience pulling and working with healthcare data to find trends or errors and summarize results.

Experience working in an electronic health record or revenue cycle system.

Ability to write clear documentation, such as process notes, SOPs, or reports.

Proficiency in Microsoft Excel (pivot tables, lookups, and basic formulas), plus working proficiency in Word and PowerPoint.

Strong attention to detail and the ability to manage multiple tasks and deadlines.

Clear written and verbal communication skills.

Willingness to learn new systems, federal regulations, and client processes.

Bachelor's degree in healthcare administration, business, finance, accounting, or a related field.

U.S. citizenship and the ability to obtain and maintain a Public Trust.

Desired Skills and Experience:

Proficiency with electronic health record and revenue cycle software and systems, such as:

Electronic Health Record systems (Oracle/Cerner MHS GENESIS Patient Accounting Module CPAM)

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)

Data analytics tools (Excel, Power BI, SAS, Tableau, Qlik Sense) / repositories (Excel, MHS GENESIS, ABACUS, M2, MDR, EAS IV, Health Data Intelligence/HealtheAnalytics)

Hands-on experience in back-end functions, such as billing, claims follow-up, denials management, payment posting, or collections.

Experience supporting compliance reviews, audit readiness, or corrective action plans.

Experience developing training materials or delivering training.

Experience supporting the MHS, DHA, Veterans Health Administration (VHA), or other federal healthcare organizations.

Certified Revenue Cycle Representative (CRCR) or a similar revenue cycle certification.