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.