Director, HRMA | Forensic & Litigation Consulting

Healthcare Risk Management & Advisory Director

FTI Consulting is the leading global expert firm for organizations facing crisis and transformation. We work with many of the world's top multinational corporations, law firms, banks and private equity firms on their most important issues to deliver impact that makes a difference. From resolving disputes, navigating crises, managing risk and optimizing performance, our teams respond rapidly to dynamic and complex situations.At FTI Consulting, you'll work side-by side with leaders who have shaped history, helping solve the biggest challenges making headlines today. From day one, you'll be an integral part of a focused team where you can make a real impact. You'll be surrounded by an open, collaborative culture that embraces diversity, recognition, professional development and, most importantly, you.Are you ready to make your impact?

What You'll Do

Our Directors work within diverse teams of professionals that include experienced nurse reviewers, coding professionals, and physicians to assist clients and counsel in reviewing medical records to independently evaluate the services provided and compliance with various regulations. Reviews may focus on particular coding issues, medical necessity, or clinical documentation improvement. Directors are asked to review medical records, document their findings and rationale for decisions (based on coding, clinical or regulatory requirements) and discuss them with project management, client and counsel.

• Examine outpatient, physician office, and inpatient medical records; review principal and secondary diagnoses and procedures, applying strong understanding of clinical documentation and care delivery workflows.
• Validate accuracy of code assignments (ICD-10-CM/PCS, CPT, HCPCS, MS-DRG, HCCs) and confirm appropriate reimbursement based on medical record documentation.
• Ability to research billing, coding, and reimbursement regulations and summarize issues for discussions with client and counsel, citing relevant regulatory sources
• Articulates complex coding and clinical terminology or ambiguous guidance for client and counsel.
• Prepare detailed written analyses of medical record reviews and coding findings, including citations to applicable regulatory requirements and coding guidelines.

How You'll Grow

We are committed to investing and supporting you in your professional development and we have developed a range of programs focused on fostering leadership, growth and development opportunities. We aim to promote continuous learning and individual skills development through on-the-job learning, self-guided professional development courses and certifications. You'll be assigned a dedicated coach to mentor, guide and support you through regular coaching sessions and serve as an advocate for your professional growth.

As you progress through your career at FTI Consulting, we offer tailored programs for critical professional milestones to ensure you are prepared and empowered to take on your next role.

What You Will Need To Succeed

• Ability to work both independently and as part of a team in a fast-paced, multi-task environment with a strong attention to detail.
• Ability to interface and be collaborative with team members and client personnel in demanding, deadline-driven situations.
• Excellent communication (both written and verbal) and organizational skills
• Flexibility with respect to assigned tasks and engagements due to challenging deadlines, changing deliverables and evolving task priorities.
• Strong work ethic, eagerness to learn, and motivation to succeed

Basic Qualifications

• Bachelor's Degree
• Current/active coding certification: Certified Professional Coder (CPC), Certified Coding Specialist (CCS) and/or Certified Outpatient Coder (COC)
• 5+ years medical coding or clinical documentation improvement experience preferably in a consulting/professional services environment.
• Proficient use of grouper software and/or coding reference books to determine appropriate code assignment
• Experience using EMR's such as EPIC, Cerner, Athena, AdvancedMD
• Proficient in use Microsoft Office Suite, including Outlook, Word, Excel and PowerPoint
• Must be willing to travel periodically, some travel may be required (up to 30% annually).
• This role requires travel to clients and FTI offices
• Applicants must be currently authorized to work in the United States on a full-time basis; this position does not provide visa sponsorship

Preferred Qualifications

• Knowledge of APC assignment logic, National Correct Coding Initiative edits, ICD-10-CM/PCS Official Coding Guidelines, AHA Coding Clinic, and CPT Assignment coding guidelines
• Medical Laboratory Scientist (MLS) ASCP Certification or corresponding experience in a laboratory setting
• Testifying, mediation or arbitration experience
• Demonstrated experience in the fundamentals of auditing and monitoring

FTI Consulting is an equal opportunity employer and does not discriminate on the basis of race, color, national origin, ancestry, citizenship status, protected veteran status, religion, physical or mental disability, marital status, sex, sexual orientation, gender identity or expression, age, or any other basis protected by law, ordinance, or regulation.

Compensation: Minimum Pay:$91,000Maximum Pay:$278,000

Compensation Disclosure: The compensation range reflects potential base salary for the role. Actual compensation is determined based on a wide array of relevant factors including market considerations, business needs, and an individual's location, skills, level of experience, and qualifications.