Senior Managing Consultant - Revenue Integrity - Healthcare

About the role

The Revenue Integrity team at Berkeley Research Group (BRG) is seeking a Senior 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, along with 7+ years of consulting and/or industry work experience in Revenue Integrity and/or Charge Integrity.

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.
• 7+ 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 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

The Senior Managing Consultant at BRG will earn a salary range of $166,000 – $199,000 per year. Compensation and benefits are determined based on qualifications and experience.

Schedule

The Senior Managing Consultant position requires consistent travel (50% - 75%) depending on project requirements and client expectations.

Pay

The Senior Managing Consultant at BRG will earn a salary range of $166,000 – $199,000 per year. Compensation and benefits are determined based on qualifications and experience.

Company Overview

At Berkeley Research Group (BRG), we combine 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. 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. Our hiring practices provide equal opportunity for employment without regard to race, religion, color, sex, gender, national origin, age, United States military veteran status, ancestry, sexual orientation, marital status, family structure, medical condition including genetic characteristics or information, veteran status, or mental or physical disability so long as the essential functions of the job can be performed with or without reasonable accommodation, or any other protected category under federal, state, or local law.