Managing Consultant - Revenue Integrity - Healthcare

Role Description

The Revenue Cycle team is currently seeking a Managing Consultant to join their team. This position requires a highly motivated problem solver with solid analytical ability, strong organizational skills, and a desire to advance within the organization. An individual with an entrepreneurial spirit and an ability to apply creative solutions is a natural fit for this position. The work of a Managing Consultant will involve both execution and oversight of engagement work stream initiatives that may be either qualitative or quantitative in nature, and responsibilities include:

• Design of financial analysis
• Development and presentation of client deliverables
• Management of existing client relationships
• Industry research
• Expansion of business

Willing to travel consistently (50% - 75%), depending on project requirements and client expectations, is required for this position.

Responsibilities

• Assess and analyze charge generation and charge capture workflows to identify potential revenue leakage issue(s) and/or compliance risks
• Review and/or draft Revenue Integrity related policies and procedures to identify improvement recommendations
• Perform detailed research and analysis (e.g., gather, review, and summarize literature and data from the public domain, specialized industry resources, or client, public, and commercial databases)
• Demonstrate creativity and efficient use of relevant software tools, analytical methods, and computer models to develop solutions
• Develop analyses and financial models using transactional data, financial data, and/or client provided data
• Develop and execute workplans for assigned project work
• Draft client deliverables for review by project lead/manager
• Work collaboratively with internal Revenue Integrity team members to develop methodology and documentation
• Participate in a team environment and prioritize assignments and responsibilities to meet goals and deadlines; facilitate internal meetings as appropriate

Qualifications

• A Bachelor’s or Master’s degree (e.g., BS, BBA, MBA, MHA, M.A., M.S., etc.) with a preferred focus in Management, Accounting, Finance, Healthcare Administration, Business Administration, Health Information Management or related discipline
• 4-8 years of consulting and/or industry work experience in Revenue Integrity and/or Charge Integrity including performance and process improvement, revenue management and redesign, and reimbursement and recovery strategies
• Operational expertise with a primary focus on Charge Description Master (CDM) Management, Charge Capture, Revenue Integrity, Denials Prevention, HIM/Coding/Outpatient Clinical Documentation Improvement, Denials Prevention, and Payer Contracting
• Understanding of the Medicare IPPS, OPPS and ASC payment systems
• Understanding of documentation and various charge capture and charge generation processes across high-volume, revenue-producing hospital departments
• Understanding of charge reconciliation processes
• Familiarity with compliance principles as related to Revenue and Charge Integrity
• Familiarity with regulatory changes that impact charging practices
• Familiarity with clinical operations and billing office workflows
• Strong verbal and written communication and presentation skills
• Strong proficiency in MS Office applications, including Word, PowerPoint, Excel, Access, and Outlook
• Applicable industry certification is preferred (e.g., RHIA, RHIT, CPC, COC, CCS, CRIP or other AHIMA / AAPC / AAHAM certification)
• Familiarity with various EMRs (e.g. Epic, Cerner, Allscripts, MEDITECH, Athena/IDX)

Requirements

• Consultant Salary Range: $90,000 – $135,000 per year
• Managing Consultant Salary Range: $120,000 – $165,000 per year
• Job title and compensation to be determined based on qualifications and experience
• Candidate must be able to submit verification of his/her legal right to work in the U.S., without company sponsorship

Company Description

BRG combines world-leading academic credentials with world-tested business expertise and purpose-built emerging technologies. Our culture centers on agility and connectivity which sets us apart and gets you ahead.

• At BRG, our professionals include specialist consultants, industry experts, renowned academics, and leading-edge data scientists.
• Together, they bring a diversity of real-world experience, data, and human and artificial intelligence, to economics, disputes, and investigations; corporate finance; and performance improvement services that address the most complex challenges facing organizations across the globe.
• Our unique structure nurtures the interdisciplinary relationships that give us the edge, laying the groundwork for more informed insights and more original, incisive thinking.
• When paired with our global reach and resources, our diverse perspectives and technical capabilities make us uniquely capable to address our clients’ challenges.
• We get results because we know how to apply our thinking to your world.
• At BRG, we don’t just show you what’s possible. We’re built to help you make it happen.
• BRG is proud to be an Equal Opportunity Employer.