Managing Consultant – Revenue Integrity, Healthcare

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Berkeley Research Group (BRG)

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

💰 Venture Round on 2020-07

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, we are an integrated group of experts, industry leaders, academics, data scientists, and professionals working beyond borders and disciplines. We harness our collective expertise to deliver the inspired insights and practical strategies our clients need to stay ahead of what's next.

📋 Description

• Assess and analyze charge generation and charge capture workflows to identify potential revenue leakage issue(s) 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. • Participate in a team environment and prioritize assignments and responsibilities to meet goals and deadlines; facilitate internal meetings as appropriate.

🎯 Requirements

• 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. • Understanding of 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

• Health insurance • Flexible working hours • Professional development opportunities