Domain RCM Functional SME – Order-to-Cash

Domain RCM Functional SME – Order-to-Cash
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Location : Durham NC (Hybrid)
Job TitleRCM Functional SME – Order-to-Cash (Laboratory Revenue Cycle Management)2. Role SummaryThe RCM Functional SME – Order-to-Cash will assess and optimise the end-to-end laboratory revenue cycle, from order intake through cash realisation. The role will identify process gaps, revenue leakage, denial drivers, and data-quality issues while improving clean-claim rates, reimbursement outcomes, collections, and operational efficiency.3. Key ResponsibilitiesLead the functional assessment of the complete laboratory Order-to-Cash lifecycle.Assess front-end workflows covering EHR/CPOE orders, demographics, eligibility, authorisation, and medical necessity.Evaluate coding, pricing, charge capture, claim submission, denial management, appeals, cash posting, and A/R processes.Identify upstream data-quality issues and root causes of payer edits, rejections, denials, delayed payments, and revenue leakage.Collaborate with business, laboratory, billing, payer, and IT stakeholders to define current-state gaps and improvement recommendations.4. Required Skills & Experience10+ years of experience in healthcare Revenue Cycle Management, with strong Order-to-Cash expertise.Deep functional knowledge of laboratory billing, claims, denials, appeals, cash posting, collections, and Accounts Receivable.Experience with EHR/CPOE, patient demographics, eligibility verification, prior authorisation, and medical necessity workflows.Proficiency in process assessment, gap analysis, root-cause analysis, workflow mapping, and revenue-leakage identification.Strong analytical, stakeholder-management, workshop-facilitation, requirements-documentation, and communication skills.5. Preferred SkillsExperience in laboratory diagnostics and Laboratory Information Systems (LIS).Knowledge of US healthcare payer rules, reimbursement models, coding, and compliance requirements.Experience with Epic, Oracle Health/Cerner, Meditech, or similar healthcare platforms.Exposure to revenue integrity, denial analytics, workflow automation, or AI-enabled RCM solutions. xzbcwsv Good to have - Relevant certification in Revenue Cycle Management, healthcare operations, coding, Lean Six Sigma, or healthcare compliance.