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Role Description

The Revenue Cycle Optimization Consultant is responsible for the review, development, and continual improvement of the Charge Description Master (CDM) across assigned TruBridge clients. This role ensures CDM compliance with federal and state regulations, optimizes charge capture processes, and collaborates with operations teams and clients to ensure Charge master is current and up to date.

• Acts as a subject matter expert (SME) in CDM strategy, ensuring consistent and compliant practices.
• Identifies opportunities to enhance reimbursement and operational efficiency.
• Performs CDM reviews and maintenance to ensure CDM is updated timely and accurately in accordance with CMS quarterly updates.
• Obtains quarterly update files to update the tool used to conduct chargemaster reviews.
• Collaborates with Revenue Cycle, Compliance, Clinical Leadership, Finance, and IT to standardize CDM practices and align with enterprise goals.
• Maintains abreast of quarterly OPPS changes as published in the OPPS.
• Supports CBO annual charge master updates based on CMS, AMA, and payer regulatory changes.
• Meets with clients to discuss their worklist of items to be corrected and follows up to ensure corrections are made.
• Educates clients on proper chargemaster maintenance, especially when adding new charge items.
• Utilizes datamining to identify CBO clients having high Original Errors or Denials due to item master errors.
• Collaborates with Compliance, TBEHR Financial Support, RCM, and CBO to suggest RCM edits and updates to company documents.
• Establishes and monitors KPIs, reporting dashboards, and operational benchmarks for CDM performance.
• Supports pricing transparency, chargemaster publication requirements, and compliance with No Surprises Act.
• Leads the CDM function during major initiatives such as EHR transitions, acquisitions, or new program launches.

Qualifications

• 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.

Requirements

• General office environment: Works at a desk in a well-lighted, air-conditioned cubicle/office, with moderate noise levels.
• Periods of stress may occur.
• Activities require a significant amount of sitting at office and work desks and in front of a computer monitor.
• Some walking and standing relative to interaction with other personnel.
• Occasional travel - 25% or less.

Company Description