Managing Consultant – Revenue Integrity – Healthcare

🔥 18 hours 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

• Plan and manage small- to medium-sized Revenue Integrity engagements and discrete workstreams within larger multidisciplinary engagements • Lead initiatives across Charge Description Master governance, charge capture, charge reconciliation, charging compliance, revenue integrity-related denials prevention, and financial opportunity realization • Lead current-state assessments of Revenue Integrity operations • Quantify financial and compliance opportunities, identify root causes, and develop prioritized recommendations and implementation roadmaps • Assess and analyze charge-generation and charge-capture workflows to identify revenue leakage and compliance risks • Review and draft Revenue Integrity-related policies and procedures and recommend improvements • Develop and maintain relationships with client executives, operational leaders, and key stakeholders • Apply technology, analytical methods, and financial models to develop data-driven solutions • Develop analyses and financial models using transactional, financial, and client-provided data • Develop and manage project charters, work plans, budgets, staffing plans, timelines, risks, deliverables, and benefit realization models and schedules • Monitor performance against financial, operational, and compliance targets to support project execution and engagement profitability • Lead design and implementation of future-state Revenue Integrity processes, governance structures, controls, policies, and monitoring tools • Lead development, quality review, and presentation of client deliverables, findings, and recommendations • Collaborate with Revenue Integrity team members to develop methodologies, analytical tools, implementation playbooks, and supporting documentation • Lead project teams, delegate responsibilities, monitor progress, facilitate meetings, and review work products • Present findings, recommendations, project progress, risks, and financial results to senior client stakeholders

🎯 Requirements

• 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 • 5+ years of consulting and/or industry experience in Revenue Integrity, Charge Integrity, or related revenue cycle functions • Demonstrated experience leading performance improvement, process redesign, reimbursement, and revenue recovery initiatives • Operational expertise in Charge Description Master governance and maintenance, charge capture, charge reconciliation, Revenue Integrity, denials prevention, HIM/coding, outpatient clinical documentation improvement, pricing, reimbursement, and/or charging compliance • Working knowledge of Medicare IPPS, OPPS, and ASC payment systems and their impact on charging, coding, billing, and reimbursement practices • Working knowledge of clinical documentation, charge-generation, charge-capture, and charge-reconciliation processes across high-volume, revenue-producing hospital departments • Working knowledge of applicable charging, coding, billing, reimbursement, compliance, and price transparency requirements • Ability to assess operational and financial impact of regulatory changes • Familiarity with clinical operations and patient financial services workflows • Strong written, verbal, and presentation skills • Strong proficiency in Microsoft Office applications, including Word, PowerPoint, Excel, and Outlook • Familiarity with various EMRs, including Epic, Oracle Health/Cerner, Altera/Allscripts, MEDITECH, and athenahealth/IDX • Applicable industry certification is preferred, such as RHIA, RHIT, CPC, COC, CCS, CRIP, or other AHIMA/AAPC/AAHAM certification • Ability to travel 50% to 75%, depending on project requirements and client expectations • Must be able to submit verification of legal right to work in the U.S. without company sponsorship

🏖️ Benefits

• Equal Opportunity Employer • Reasonable accommodation for essential job functions