As RCM Expert, you will take a lead role in managing large scale transitions and delivering client success. The RCM Expert works closely with the RCM and Transitions teams and clients to ensure seamless and successful transition of contracted RCM functions of the practice, hospital and/or health system. The RCM Expert will work with customers and prospects as a subject matter expert representing Cognizant's products and services. The RCM Expert provides consultative reviews of revenue cycle performance and recommends process changes and/or improvements to impact overall performance and efficiency of the provider. This role is a high visibility and challenging opportunity and requires high amount of commitment, business acumen, leadership qualities and motivated attitude to perform well.

Essential Functions / Tasks / Duties / Responsibilities:

* Develop trusted advisor relationships with healthcare leadership and provide strategic guidance

* Lead complex transition engagements improving financial outcomes for clients

* Perform due diligence during the transition period to align with the contractual obligations and set expectations on the transition with the client and internal stake holders.

* Document and create Work Instructions (WIs) and Standard Operating Procedures (SOPs).

* Effectively communicate with clients, internal teams and stakeholders to provide updates on the progress of transition.

* Assist with establishing and monitoring KPIs to evaluate the success of transition projects and make data driven decisions.

* Provide expertise in revenue cycle, clinical integration, and financial turnarounds

* Design innovative solutions to pressing revenue cycle challenges

* Proactively manages client requests for additional information as it relates to: revenue cycle services, opportunity identification, etc.

* Contribute to practice strategy, capability development, talent acquisition

* Build strategic relationships with clients, assuring that they are fully leveraging all of Cognizant RCM capabilities, products and services

* Evaluate then recommend best practices to ensure outcomes that will meet client expectations

* Collaborates with team members and clients to determine current process gaps and assist with developing future processes.

* Investigates claims using the A/R Analysis Report, Claims and AR, rejections and acknowledgements, and any other tools necessary to determine and resolve problems for the client's revenue cycle.

* Reports and discusses inconsistencies and/or discrepancies found during our analysis of the clients end to end rcm processes.

* Ability to represent and effectively communicate results to executive leadership at provider offices and hospitals and health systems

* Participates in professional/company development activities

* Ensures strict confidentiality of client records

* Meets routine deadlines and work schedules as well as timely and accurate completeness of special projects

* Monitor industry dynamics and competitive forces to identify growth opportunities

* Continuously expand knowledge of emerging trends, technologies, and best practices

* Understands, supports, enforces, and complies with Company policies, procedures and Standards of Business Ethics and Conduct

* Maintains proficiency and level of knowledge with all systems required for task completion

* Ensures compliance with all state and federal billing regulations and reports any suspected compliance issues to the respective Manager/Supervisor

* Performs miscellaneous duties as assigned

Education / Professional Certifications or Licenses Required:

* Degree in Business Administration or related experience

* MGMA ACMPE membership/knowledge (a plus)

* CPC (a plus)

Experience Requirements:

* 10+ years in healthcare operations, consulting, or related fields

* Passion for collaborating with clients to drive tangible improvements

* Entrepreneurial mindset and proven business development track record

* Expert knowledge of revenue cycle management across the care continuum

* Experience advising senior healthcare executives

* Strong communication, presentation, and storytelling abilities

* Commitment to developing talent and fostering client success

* Experience working in a medical practice environment

* Experience in Pediatrics and Behavioral Health medical billing

* Client relations

* Process improvement

* Proficient with Microsoft Office Suite and Google Docs

* Salesforce knowledge

* CPT and ICD10 knowledge

Education / Professional Certifications or Licenses Required:

* Degree in Business Administration or related experience

* MGMA ACMPE membership/knowledge (a plus)

* CPC (a plus)

Experience Requirements:

* 10+ years in healthcare operations, consulting, or related fields

* Passion for collaborating with clients to drive tangible improvements

* Entrepreneurial mindset and proven business development track record

* Expert knowledge of revenue cycle management across the care continuum

* Experience advising senior healthcare executives

* Strong communication, presentation, and storytelling abilities

* Commitment to developing talent and fostering client success

* Experience working in a medical practice environment

* Experience in Pediatrics and Behavioral Health medical billing

* Client relations

* Process improvement

* Proficient with Microsoft Office Suite and Google Docs

* Salesforce knowledge

* CPT and ICD10 knowledge