Managing Consultant - Revenue Integrity - Healthcare

About the role

The Revenue Cycle team at Berkeley Research Group (BRG) is 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. The ideal candidate should have a Bachelor’s or Master’s degree with a focus in Management, Accounting, Finance, Healthcare Administration, Business Administration, Health Information Management, or a related discipline. They should also have 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.

Responsibilities

• Assess and analyze charge generation and charge capture workflows to identify potential revenue leakage issues 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.
• 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.
• Familiarity with 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).

Benefits

Managing Consultant Salary Range: $120,000 – $165,000 per year.

Pay

Candidate must be able to submit verification of his/her legal right to work in the U.S., without company sponsorship.

Schedule

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