Five Emerging Mid-Revenue Cycle Roles

By Brian Murphy

New job functions will be needed to meet the changing nature of healthcare delivery and reimbursement. And soon.

Here are five. These are my predictions but I feel good about them.

Note: Many/most of these exist in some form or fashion now, but I believe the demand will grow, and explain why.

  1. TEAM coordinator. CMS has doubled down on bundled payments with the new Transforming Episode Accountability Model (TEAM) model.  Released in the 2025 Inpatient Prospective Payment System (IPPS) 2025 rule, TEAM is a five-year, mandatory episode-based payment model that starts in January 2026. It includes Lower Extremity Joint Replacements, Surgical Hip Femur Fracture Treatments, Spinal Fusions, Coronary Artery Bypass Grafts, and Major Bowel Procedures, stratifies risk in 3 tracks, and assesses performance by comparing actual Medicare FFS spending to a target price, as well as how hospitals perform on quality measures (readmissions, patient safety, and patient-reported outcomes). CDI and coding professionals can impact model performance by ensuring patients are appropriately included or excluded by ICD-10 code. But someone will have to manage the process and ensure their organization is meeting quality and financial targets.
  2. Data analyst/informaticist. Big data is the future of medicine. Being able to track diagnosis capture by specialty or down to the individual provider level is powerful, and can reveal critical areas of opportunity. For example, a CDI informaticist may drill down to PSI 11 (postoperative respiratory failure rate), producing a report of how often this diagnosis is being reported, and by which specialties, to launch new documentation improvement or quality improvement interventions, or offer targeted education.
  3. Epic liaison. Technology adoption is exploding, and EHRs including (but not limited to) Epic are increasingly adding on elements that impact the revenue cycle. These include point of care prompts to providers, generative artificial intelligence that create progress notes, etc. But, much can’t be used out of the box. It requires turning on some pieces, “sleeping” others, educating providers etc. This requires a liaison between the vendor and IT.
  4. Managed care coordinator/risk adjustment liaison. One of the most basic ways to move the risk adjustment needle in an organization is to just get your patients seen annually. To schedule annual wellness visits and then ensure that patients aren’t missing appointments. Providers need to be teed up with the right information pre-visit.
  5. Pilot project manager. Given the number of new initiatives (see above) you could start, doing them all at once is not feasible. One way to dip your toe in the water is through a pilot project. For example, piloting social determinants of health (SDOH) capture in a couple of clinics before rolling it out organization-wide. This requires someone who understands both the documentation and coding aspects, but also clinic workflows coupled with strong project management skills.

Coding/CDI professionals with the gumption and desire to learn are well-positioned to grow into these roles.

The times are changing but I think the future is bright.

What roles do you think will be needed?

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