Healthcare Coding Medicare KPIs CMS HIPPA EPIC Prelude Certification Workflow Consult

COOLSOFT; Raleigh (NC); Hybrid; USD 120,000 - 150,000; Full time

Job summary

COOLSOFT in Raleigh, NC seeks a Consultant to lead revenue cycle operations for DHHS/IT. You will oversee patient access, HIM, coding, billing, denial management, and payer relationships across facilities.

The role requires deep knowledge of CMS/Medicare, HIPAA, and Epic Prelude/Cadence/Resolute, plus proven leadership of enterprise teams and KPI improvement.

Qualifications

• Knowledge of full healthcare revenue cycle operations including patient access, HIM, coding, billing, A/R and denials.
• Understanding of Medicaid, Medicare, and commercial payer reimbursement.
• Experience leading enterprise revenue cycle teams with managers and specialized staff.
• Ability to develop and execute revenue cycle strategy aligned with financial and compliance objectives.
• Expertise managing KPIs such as A/R days, denial rate, clean claims and net collections.

Responsibilities

• Provide leadership and strategic direction for end-to-end revenue cycle operations.
• Oversee patient access, coding, billing, A/R, payer management and collections.
• Drive strategy to optimize financial performance and cash flow while ensuring compliance.
• Partner with senior leadership, state agencies and payer organizations.

Skills

Healthcare

Coding

Medicare

CMS

HIPAA

Epic Prelude

KPIs

Workflow governance

Tools

Epic Prelude

Epic Cadence

Epic Resolute

Job description

Healthcare Coding Medicare KPIs CMS HIPPA EPIC Prelude Certification Workflow Consult

Requirement id

159145

Job title

Consultant

Job location

in Raleigh, NC

Skills required

Healthcare, Coding, Medicare, KPIs CMS HIPPA EPIC Prelude Certificatio

Open Date

17-Sep-2026

Job type

Contract

Duration

7 Months

Compensation

DOE

Status requirement

---

Job interview type

---

Job Description

Consultant: Healthcare, Coding, Medicare, KPIs CMS HIPPA EPIC Prelude Certificatio

Start date

10/1/2026

End Date

04/01/2027

Submission deadline

09/23/2026

Client Info

NCDHHS-IT Budget Office

Note

• Work Arrangement: Hybrid
• Agency Interview Type: Either Webcam Interview or In Person

Description

DHHS is seeking a Revenue Cycle Management (RCM) Program Director to provide leadership and strategic direction for all end-to-end revenue cycle operations across DSOHF facilities, including patient access, health information management, coding, billing, accounts receivable, payer management, and collections. This role drives strategy to optimize financial performance, ensure regulatory compliance, minimize denials, and improve cash flow while guiding a multi-tiered team of managers and staff.

The Director partners with senior leadership, state agencies, and payer organizations to align operations with financial goals, oversees key metrics and reporting, manages complex Medicaid/Medicare billing requirements, ensures audit readiness, and guides technology optimization within Epic and related systems to continuously improve efficiency and accountability.

Skills set

Knowledge of full healthcare revenue cycle operations (patient access, HIM/coding, billing, A/R, denials).

Understanding of Medicaid, Medicaid Managed Care, Medicare, and commercial payer reimbursement.

Experience leading enterprise revenue cycle teams with managers and specialized staff.

Ability to develop and execute revenue cycle strategy aligned with financial and compliance objectives.

Expertise managing KPIs such as A/R days, denial rate, clean claims, and net collections.

Strong knowledge of CMS, HIPAA, state regulations, and payer policies.

Skill in maintaining internal controls, audit readiness, and compliance frameworks.

Proficiency with Epic revenue cycle systems (Prelude, Cadence, Resolute HB/PB) and workflow governance.

Ability to lead technology optimization, analytics, automation, and reporting.

Strong partnership and collaboration skills across finance, clinical operations, IT, compliance, and payer organizations.

Executive communication ability to present complex financial, operational, and regulatory information.

Financial acumen to evaluate trends, forecast cash, assess reimbursement risks, and drive improvements.

Competence in leading organizational change, standardization, and continuous improvement initiatives.

Understanding of revenue cycle considerations for behavioral health, psychiatric care, developmental disabilities, and state-operated facilities.

EOE Protected Veterans/Disability