Civeng00,
Regarding the skew, that is exactly what I mean. The hydraulic reference manual of RAS has a good explanation of doing skew. And I also made a boo-boo. The cutoff for not skewing the bridge is 20 degrees, not 30. Me bad. And yes, skewing a bridge will always decrease its hydraulic efficiency, so your water surface elevations will go up.
Many items can be georeferenced into RAS using various coordinate systems. You can take the coordinates of your stream channel thalweg, bank stations, cross sections, etc. from AutoCAD or MicroStation and input them into the RAS georeference tables, and the program will draw the system for you. Then when you enter the bridge, it will be lined up properly with everything else.
However, it is not required to georeference anything to run a RAS model. Just ignore the perspective view, which will be totally useless.