Senior RCM Consultant

Trifork

RCM product and functional leadership

• Serve as the RCM domain lead throughout system design, enhancement, and rollout phases

• Translate end-to-end hospital revenue cycle workflows including patient registration, medical coding, billing, claiming, reconciliation, and reporting into structured functional and system requirements

• Review solution designs and validate that RCM and Billing modules reflect operational realities and Ministry standards

• Provide continuous functional guidance to business analysts and software development teams during product evolution

Testing, validation, and structured implementation

• Lead functional testing, scenario-based validation, and User Acceptance Testing.

• Validate complete claiming workflows, including pre-authorisation, billing rules, submissions, rejections, and resubmission processes.

• Ensure outputs meet financial, regulatory, and clinical governance requirements.

• Support hospitals during onboarding, go-live, and post-implementation phases.

Claiming, coding, and compliance

• Provide subject matter expertise on insurance models, reimbursement mechanisms and post-office insurance workflows.

• Guide hospitals and medical coders in applying recognised coding standards (ICD, CPT, HCPCS, or equivalent).

• Support alignment between local practices and internationally recognised standards.

• Promote coding accuracy, consistency, and compliance across institutions.

Governance and stakeholder engagement

• Contribute to the development and refinement of national RCM, Billing, and Claiming policies and procedures.

• Act as a trusted functional advisor to Ministry stakeholders on RCM governance and operating models.

• Facilitate structured workshops and design sessions.

• Identify operational gaps and recommend system or process improvements.

• Coordinate across hospitals, IT teams, and external partners to ensure alignment.

You are an experienced RCM professional with both operational depth and strategic awareness. You are comfortable navigating complex healthcare environments and working with both clinical and technical stakeholders.