RCM CONSULTANT.

Strategic Roles & Responsibilities

• Develop and implement strategies to optimize charge capture processes ensuring alignment with best practices and maximizing revenue capture
• Oversee any relevant integration and enhancement of EMR HIS LIS and billing systems to Ensure seamless and efficient charge reconciliation
• Lead initiatives to innovate and refine charge capture tools such as Flowsheets and Smart Forms to enhance automation and accuracy
• Formulate and execute strategies for the ongoing development and management of the Charge Description Master including the strategic addition or deletion of charges
• Design and implement strategic approaches to address and prevent claims denials focusing on root cause analysis and longterm resolution
• Drive continuous process improvement initiatives for charge setup and management to enhance operational efficiency and effectiveness
• Utilize data analytics and insights to inform strategic decisions related to charge capture billing processes and revenue cycle management driving overall operational excellence

Operational Roles & Responsibilities

• Evaluate current revenue cycle processes to identify inefficiencies bottlenecks and compliance issues and analyze data for performance and effectiveness
• Create and present actionable recommendations to improve billing coding collections and patient account management
• Oversees implementing process improvements system upgrades and staff training to Ensure effective integration of changes
• Ensure adherence to regulations and industry standards identifying and mitigating risks in billing coding and reimbursement
• Engage regularly with healthcare administrators finance teams and IT departments to understand needs and provide tailored solutions including workshops and training
• Set and track key performance indicators KPIs to measure the success of changes and provide ongoing support to achieve desired results
• Oversee charge Description Master CDM maintenance charge capture processes and clinical code management including handling charge automation and denial resolutions
• Guide and train clinical teams align work with organizational goals and promote professional growth while performing additional duties as assigned

Functional Competencies

Core Competencies