Module 1 · 4.5h
Foundations of Healthcare Revenue Cycle Management
Understand the U.S. healthcare ecosystem, the revenue cycle end-to-end, and why RCM matters.
Healthcare ecosystem & stakeholdersEnd-to-end revenue cycle mapPayer & reimbursement modelsPatient financial journeyGen AI: orientation & RCM use-case landscape
Module 2 · 5h
Front-End Operations
Master scheduling, registration, eligibility, prior auth, and patient financial clearance.
Scheduling & pre-registrationEligibility & benefits verificationPrior authorization workflowsPatient financial clearance & estimatesFront-end KPIs & staffing modelsAgentic AI: automated eligibility, auth & intake bots
Module 3 · 4.5h
Medical Coding & CDI
Build coding literacy: ICD-10-CM, ICD-10-PCS, CPT, HCPCS, modifiers, NCCI, and CDI fundamentals.
ICD-10-CM, ICD-10-PCS, CPT, HCPCSModifiers & NCCI editsCDI fundamentals & query workflowsE&M coding (1995/1997/2021)Coding audits & risk adjustmentGen AI: computer-assisted coding & CDI copilots
Module 4 · 4h
Claims, Billing & EDI
The 837/835/270/271/277 transactions, clearinghouses, claim scrubbing, and electronic remittance.
837 / 835 / 270 / 271 / 277 transactionsClearinghouses & EDI architectureClaim scrubbing & editsElectronic remittance & postingCharge capture & reconciliationAgentic AI: automated claim status & remit processing
Module 5 · 4.5h
Denials Management & A/R
Build a denial taxonomy, root-cause workflow, appeal strategy, and A/R aging discipline.
Denial taxonomy & root-cause analysisAppeals strategy & payer escalationA/R aging discipline & worklistsUnderpayment & contract variancePatient A/R & collections scriptingGen AI: appeal letter drafting & denial pattern analytics
Module 6 · 3.5h
Compliance & Regulatory
HIPAA, HITECH, NSA, 501(r), Stark/AKS, OIG work plan, and price transparency.
HIPAA & HITECHNo Surprises Act (NSA)501(r) & financial assistanceStark Law & Anti-KickbackOIG work plan & price transparencyResponsible AI: governance, PHI & bias controls
Module 7 · 4h
RCM Analytics & Technology
KPIs, dashboards, EHR/PM systems, RPA, AI in RCM, vendor selection, and implementation.
KPI design & executive dashboardsEHR & PM systems (Epic, Cerner, athena)RPA in revenue cycleGen AI in RCM (LLM use cases)Agentic AI: autonomous RCM agents & orchestrationVendor selection & implementation
Module 8 · 4h
Becoming an RCM Consultant
Engagement design, scoping, deliverables, change management, and building your practice.
Engagement design & scopingPricing & deliverablesAssessments & current-state diagnosticsChange management & stakeholder engagementBuilding your consulting practiceGen AI: proposal, deliverable & analysis acceleration
Module 9 · 3.5h
Health Equity & Financial Management
Treat health equity as a financial operating issue. Learn how disparities show up in denials, A/R, and margin — and how to redesign the revenue cycle as equity infrastructure.
Equity as a financial stress testDisparities in denials, A/R & marginSDOH data capture & workflow designEquitable patient financial experienceCare models for under-resourced communitiesResponsible AI: equity & bias in RCM models
Module 10 · 6h
Becoming a Trusted Advisor for Revenue Cycle Managers
Move from RCM operator to strategic advisor. Diagnose, prioritize, and lead transformation across the full revenue cycle.
Advisor mindset & executive presenceMGMA 13-block RCM diagnosticFront-end discipline & quality systemsDocumentation, coding & claims strategyReporting, KPIs & cash controlsChange management & Gen AI–enabled transformation
