Revenue Cycle Consultant
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Key skills for this role
About the Role
Configure and maintain Revenue Cycle Management modules, analyze workflows, provide consulting, and support integration using Java and related technologies.
Key Skills for This Role
Responsibilities
- Configure and maintain modules related to Registration, Scheduling, Billing, and Claims
- Develop and manage required components of the system based on clinical and financial requirements
- Maintain Health Plan setup, Contractual Discounts, and Claim Submission Deadlines aligned with payer rules and regulatory compliance
- Analyze and streamline RCM workflows to improve operational efficiency and financial accuracy
- Collaborate with functional and technical teams to identify bottlenecks and propose system based solutions
- Provide expert consulting to business stakeholders on RCM design decisions, interdependencies, and workflow impacts
- Support and troubleshoot integration between HIS and external systems
- Design, code, and implement enhancements using Java, DiscernDev, Custom MPage Development, and CCL/Custom Reporting
- Partner with cross functional teams to translate requirements into effective solutions
- Engage with healthcare leadership and finance teams to align system configurations with strategic RCM goals
- Provide post go live support, optimization, and issue resolution for RCM related functions
Requirements
- Bachelor's degree in Computer Science, Information Technology, or related field
- Minimum 5 years of experience in Healthcare Information Systems (HIS) with a focus on Revenue Cycle Management
- Proven expertise in Revenue Cycle modules (Registration, Scheduling, Charge Services, Patient Accounting, HIM etc)
- Experience working with Health Insurance Post Offices (e.g., Riayati, DHPO)
- Hands on experience with CCL, MPage Development, DiscernDev, and Java programming
- Strong understanding of health plan configuration, claim workflows, charge capture, and discount management
- Excellent English communication skills, both verbal and written
- Excellent analytical, problem solving, and documentation skills
- Willingness to travel and support on site as needed
- Proactive and detail oriented with a focus on quality and results
Full Job Posting
What you will do
- Configure and maintain modules related to Registration, Scheduling, Billing, and Claims.
- Develop and manage required components of the system based on clinical and financial requirements.
- Maintain Health Plan setup, Contractual Discounts, and Claim Submission Deadlines aligned with payer rules and regulatory compliance.
- Analyze and streamline RCM workflows to improve operational efficiency and financial accuracy.
- Collaborate with functional and technical teams to identify bottlenecks and propose system based solutions.
- Provide expert consulting to business stakeholders on RCM design decisions, interdependencies, and workflow impacts.
- Support and troubleshoot integration between HIS and external systems.
- Design, code, and implement enhancements using Java, DiscernDev, Custom MPage Development, and CCL/Custom Reporting to meet evolving business needs.
Collaboration & Client Engagement
- Partner with cross functional teams, including Solution Architects and Business Analysts, to translate requirements into effective solutions.
- Engage with healthcare leadership and finance teams to align system configurations with strategic RCM goals.
- Provide post go live support, optimization, and issue resolution for RCM related functions.
Basic Qualifications
- Bachelor's degree in Computer Science, Information Technology, or related field.
- Minimum 5 years of experience in Healthcare Information Systems (HIS) with a focus on Revenue Cycle Management.
- Proven expertise in Revenue Cycle modules (Registration, Scheduling, Charge Services, Patient Accounting, HIM etc). Preferred
- Experience working with Health Insurance Post Offices (e.g., Riayati, DHPO), including transaction monitoring and troubleshooting.
- Hands on experience with CCL, MPage Development, DiscernDev, and Java programming.
- Strong understanding of health plan configuration, claim workflows, charge capture, and discount management.
Expectations
- Excellent English communication skills, both verbal and written.
- Excellent analytical, problem solving, and documentation skills.
- Willingness to travel and support on site as needed.
- Proactive and detail oriented with a focus on quality and results.
- Strong stakeholder management and communication skills.
- Passion for healthcare innovation and operational excellence.
- Ability to work under pressure, handle multiple priorities, and meet tight deadlines.
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