TruBridge

Clear the way for care.

Revenue Cycle Optimization Consultant

ConsultantConsultantFull TimeRemoteTeam 1,001-5,000H1B No SponsorCompany SiteLinkedIn

Location

United States

Posted

11 days ago

Salary

Not specified

Bachelor Degree4 yrs expEnglish

Job Description

• Perform CDM reviews and maintenance to ensure CDM is updated timely and accurate in accordance with the CMS quarterly updates. • Obtain quarterly update files to update the tool used to conduct chargemaster reviews. • Collaborate with Revenue Cycle, Compliance, Clinical Leadership, Finance, and IT to standardize CDM practices and align with enterprise goals. • Maintain abreast of quarterly OPPS changes. • Support CBO annual charge master updates based on CMS, AMA, and payer regulatory changes. • Meet with clients to discuss their worklist of items to be corrected; follows up with clients to ensure corrections are made. • Educate clients on proper chargemaster maintenance. • Provide suggestions for identifying proper HCPCS codes, revenue codes, and rate-setting. • Utilize datamining to identify CBO clients having high Original Errors or Denials due to item master errors. • Collaborate with Compliance, TBEHR Financial Support, RCM, and CBO to suggest RCM edits, client education, and updates to company documents as the need arises. • Establish and monitor KPIs, reporting dashboards, and operational benchmarks for CDM performance. • Support pricing transparency, chargemaster publication requirements, and compliance with No Surprises Act and related legislation as it pertains to the chargemaster. • Lead the CDM function during major initiatives such as EHR transitions, acquisitions, or new program launches.

Job Requirements

  • Bachelor’s degree in Health Information Management, Healthcare Administration, Finance, or related field (4-7+ years of experience in hospital revenue cycle/CDM management)
  • Expert knowledge of CPT, HCPCS, ICD-10, revenue codes, and payer-specific billing requirements.
  • Deep understanding of CMS regulations, compliance, and hospital reimbursement methodologies.
  • Strong leadership, communication, and analytical skills, with the ability to influence at the executive level.

Benefits

  • General office environment: Works at a desk in a well-lighted, air-conditioned cubicle/office, with moderate noise levels.
  • Periods of stress may occur.

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