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Senior Director, Healthcare Risk Management & Advisory | Forensic and Litigation Consulting

$119.5k - $329.5k

FTI Consulting, Inc.

About the Role The Healthcare Risk Management & Advisory (HRMA) practice is a high‑performing team that works across both corporate engagements and litigation matters to deliver data‑driven solutions to our clients. The healthcare industry is one of the largest, most dynamic, and complex sectors of the world economy, and the HRMA team delivers strategic, analytical, financial, data‑mining, and operational expertise through teams that understand the unique industry and regulatory environment. What You’ll Do Senior Directors work within diverse teams of professionals—including experienced nurse reviewers, coding professionals, and physicians—to assist clients and counsel in reviewing medical records. Key responsibilities include: Reviewing outpatient, physician office, and inpatient medical records; examining diagnoses and procedures; applying coding, clinical, and regulatory knowledge. Validating code assignments (ICD‑10‑CM/PCS, CPT, HCPCS, MS‑DRG, HCCs) and confirming reimbursement accuracy. Researching billing, coding, and reimbursement regulations, summarizing issues for client discussions. Articulating complex coding and clinical terminology or ambiguous guidance for internal teams, clients, and counsel. Preparing detailed written analyses of medical record reviews and coding findings with citations to regulatory requirements and coding guidelines. Guiding project strategy and approach, coordinating team efforts, reviewing complex findings, and communicating key insights and recommendations to client executives. Providing education to physicians and staff on documentation guidelines; reviewing and revising client policies related to coding and clinical documentation. How You’ll Grow FTI Consulting invests in your professional development through on‑the‑job learning, self‑guided courses, certifications, and a dedicated coach who mentors and guides you in regular coaching sessions. What You Will Need To Succeed Ability to work independently and as part of a team in a fast‑paced, multi‑tasking environment with strong attention to detail. Collaborative communication with team members and client personnel under demanding, deadline‑driven situations. Excellent written and verbal communication and organizational skills. Flexibility with assigned tasks and engagements due to changing deliverables and evolving priorities. Strong work ethic, eagerness to learn, motivation to succeed, critical thinking, problem‑solving, analytical, and presentation skills. Basic Qualifications Bachelor’s degree (required). Current/active coding certification: Certified Professional Coder (CPC), Certified Coding Specialist (CCS), or Certified Outpatient Coder (COC). 10+ years of total working experience. 8+ years of medical coding or clinical documentation improvement experience (preferably in consulting or professional services). Proficient use of grouper software and/or coding reference books. Experience using EMR systems such as EPIC, Cerner, Athena, or AdvancedMD. Proficient in Microsoft Office (Outlook, Word, Excel, PowerPoint). Willingness to travel periodically (up to 30% annually). Authorized to work in the United States on a full‑time basis (no 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 equivalent laboratory experience. Testifying, mediation, or arbitration experience. Experience in auditing and monitoring fundamentals. Compensation Minimum Pay: $119,500 – Maximum Pay: $329,500. The compensation range reflects potential base salary. Actual compensation will depend on market considerations, business needs, location, skills, level of experience, and qualifications. Equal Employment Opportunity 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. #J-18808-Ljbffr FTI Consulting, Inc.

Vacancy posted 5 days ago
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