Managing Consultant – Coding, Middle Revenue Cycle, Healthcare

🔥 3 minutes ago

🇺🇸 United States – Remote

💵 $120k - $165k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

💼 Consultant

👻 Ghost score 0%

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Berkeley Research Group (BRG)

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

🏗️ Construction

📦 Logistics

🎖️ Defense

💰 Venture Round on 2020-07

Construction • Logistics • Defense

Berkeley Research Group (BRG) is a global consulting firm that helps leading organizations advance in the fields of corporate finance; economics, disputes, and investigations; and performance improvement. With offices around the world, BRG is an integrated group of experts, industry leaders, academics, data scientists, and professionals working across borders and disciplines. The firm specializes in various sectors, including construction, energy, technology, and healthcare, delivering inspired insights and practical strategies to help clients navigate their challenges effectively.

📋 Description

• Lead and support qualitative and quantitative engagements focused on coding accuracy, compliance, productivity, timeliness, reimbursement, and financial performance • Support expansion of BRG’s middle revenue cycle capabilities across coding, clinical documentation integrity, health information management, charge capture, revenue integrity, denials prevention, reimbursement, and related functions • Plan and manage small- to medium-sized coding and middle revenue cycle engagements and workstreams • Lead assessments of coding, clinical documentation integrity, health information management, and related middle revenue cycle operations • Develop project charters, work plans, staffing and budget plans, schedules, risk registers, client deliverables, and benefit realization models • Manage project teams, delegate work, review analyses and deliverables, and monitor scope, staffing, budgets, timelines, and engagement performance • Identify operational, financial, compliance, workforce, and technology opportunities; develop recommendations and implementation roadmaps • Present findings, recommendations, project progress, risks, and financial results to client leaders • Assess coding accuracy, compliance, productivity, timeliness, reimbursement, and financial performance across inpatient, outpatient, professional fee, and ambulatory coding • Evaluate workflows, staffing models, organizational structures, productivity standards, quality programs, management reporting, and performance management practices • Assess health information management and clinical documentation integrity processes and governance • Analyze denials, clinical validation issues, claim edits, payment variances, backlogs, documentation deficiencies, incomplete records, and late charges • Evaluate coding audit and quality assurance programs, internal/outsourced/hybrid coding models, policies, procedures, and controls • Design and support future-state operating models, workflows, governance, performance standards, and monitoring tools • Analyze coding, documentation, billing, claims, denials, workforce, and financial data; develop financial and benefit realization models • Build dashboards, KPIs, management reports, and monitoring frameworks • Assess coding, documentation, billing, claims, revenue cycle, encoder, analytics, and related technology systems • Evaluate automation, natural language processing, AI-enabled workflows, computer-assisted and autonomous coding capabilities • Support technology selection, implementation planning, workflow design, testing, adoption, training, and performance monitoring • Coordinate with technology, revenue cycle, clinical, compliance, finance, and operations teams • Build relationships with client executives and coding, health information management, clinical, compliance, and finance leaders • Collaborate across BRG’s coding, documentation, revenue integrity, patient financial services, managed care, analytics, digital, and operations teams • Develop analytical tools, benchmarks, implementation playbooks, templates, and supporting documentation • Support proposals, engagement scoping, pursuit presentations, client relationships, and follow-on opportunities • Contribute to articles, white papers, presentations, training, and thought leadership • Coach junior professionals through feedback, development support, and delegated responsibility

🎯 Requirements

• Five or more years of healthcare consulting or industry experience in coding, health information management, clinical documentation integrity, or related middle revenue cycle functions • A bachelor’s or master’s degree, such as a BS, BBA, MBA, MHA, MA, or MS, preferably in health information management, healthcare administration, business administration, finance, accounting, nursing, or a related discipline • An active RHIA, RHIT, CCS, CCS-P, CPC, CIC, COC, or comparable coding or health information management credential • Demonstrated consulting, performance improvement, process redesign, organizational transformation, or implementation experience in coding or the middle revenue cycle • Experience applying coding or health information management expertise beyond production coding or routine coding quality review • Experience leading assessments and implementation initiatives, managing concurrent workstreams, and delivering projects within scope, budget, and schedule expectations • Experience leading project teams, mentoring junior professionals, delegating assignments, and reviewing work products • Operational expertise in facility inpatient, facility outpatient, professional fee or ambulatory coding; health information management; clinical documentation integrity; computer-assisted or autonomous coding; coding quality and compliance; coding-related denials; discharged-not-final-billed management; or charge capture and revenue integrity • Current working knowledge of ICD-10-CM, ICD-10-PCS, CPT, HCPCS, modifiers, and applicable official coding guidelines • Working knowledge of Medicare IPPS, OPPS, professional fee, and ambulatory reimbursement methodologies • Knowledge of MS-DRG and APC assignment, severity capture, risk adjustment, and financial and quality effects of coding and documentation practices • Experience assessing coding productivity, quality, turnaround time, staffing capacity, organizational structure, vendor performance, and management oversight • Familiarity with coding-related denials, clinical validation, medical necessity, claim edits, and payment variance root-cause analysis • Working knowledge of regulatory and compliance requirements affecting coding, documentation, billing, reimbursement, and health information management • Experience analyzing large healthcare datasets and turning findings into financial, operational, and compliance recommendations • Strong written, verbal, and presentation skills • Ability to lead client meetings, facilitate stakeholder discussions, and build agreement around recommended changes • Ability to balance coding requirements with operational feasibility, financial impact, compliance risk, and organizational priorities • Ability to manage multiple responsibilities, workstreams, and deadlines in a consulting environment • Advanced proficiency in Microsoft Excel and PowerPoint, and proficiency in Word and Outlook • Familiarity with electronic health record, patient accounting, encoder, computer-assisted coding, clinical documentation integrity, health information management, and revenue cycle systems • Additional credentials such as CCDS, CDIP, CPMA, CHDA, PMP, Lean Six Sigma, CHFP, or CRCR are preferred