About The Position

The Healthcare Compliance Analyst position is a staff consulting position within the Healthcare Transactions and Strategy (HTS) group. HTS is currently seeking a Healthcare Compliance Analyst at the Associate or Senior Associate level. HTS performs regulatory, reimbursement, data analytics, and compliance auditing for healthcare providers, healthcare payers and healthcare investors. Compliance audit deliverables include assessment of provider compliance programs and auditing of billing and coding of clinical documents and claims documents. This position requires a highly motivated problem solver with strong analytical ability, solid organizational skills, and a desire to advance within the organization. The work of a Healthcare Compliance Analyst will involve execution of engagement work streams that will primarily involve supporting the compliance team as the team audits provider claims and provider clinical documentation with a particular focus on government programs such as Medicare and Medicaid. Responsibilities include working with team to manage and organize document intake, research coverage policies, research target companies and relevant healthcare sectors, and support the development of client deliverables and client presentations. The work of an Analyst involves execution of engagement work streams that may be either qualitative or quantitative in nature, and responsibilities include: coding and coverage research, writing, use of excel, quality control, development of client deliverables, and industry research. This specific position will require knowledge of healthcare sector and a strong interest in healthcare compliance. Candidate will be expected to obtain coding certifications (e.g. CPC) while employed. Job duties will include certified coder certification course within the first 18 months of employment with tuition paid by BRG. Job title and compensation to be determined based on qualifications and experience.

Requirements

  • 4-year undergraduate degree (e.g., BS, BA).
  • 0 to 2 years of work experience with a demonstrated interest in healthcare industry and healthcare provider billing and coding compliance.
  • Ability to research national coding and documentation guidelines; knowledge of healthcare sector and healthcare payment systems, and to develop reports, track, and trend audit findings and results.
  • Proficient user in Microsoft Office Suite, specifically Excel, PowerPoint, Access, and Word.
  • A desire to expand those capabilities is required, as is the ability to train others to use such tools.
  • Commitment to producing high quality analysis and attention to detail.
  • Excellent time management, organizational skills, and ability to prioritize work and meet deadlines.
  • Keen interest in healthcare compliance and healthcare policy.
  • Exceptional verbal and written communication skills.
  • Desire to work within a team environment.
  • Candidate must be able to submit verification of their legal right to work in the U.S., without company sponsorship.

Nice To Haves

  • Preference will be given to candidates that are certified in medical auditing.
  • Preference will be given to candidates with undergraduate academic studies that demonstrate an interest in healthcare sector and healthcare administration and management.
  • Work experience related to healthcare coding, billing and compliance or healthcare administration and management further enhances an applicant.

Responsibilities

  • Support medical record audits to determine coding accuracy and compliant claims submission with research and document management.
  • Assist with coding and documentation audit methodology including writing PowerPoint slides and compiling Excel spreadsheets under the direction of more senior auditors.
  • Conduct analysis of audit findings to identify trends/problems in coding and documentation and effectively communicates the audit findings and recommended areas for improvement.
  • Monitor relevant resources, publications, and current government compliance and enforcement activity related to high-risk compliance areas.
  • Actively pursue and obtain coding certifications (e.g. CPC) in order to advance to higher job positions as an auditor preforming full audit duties.
  • Develop analyses using transactional data and/or financial data.
  • Generate client deliverables and make valuable contributions to expert reports.
  • Demonstrate creativity and efficient use of relevant software tools and analytical methods to develop solutions.
  • Participate in group practice meetings, contribute to business development initiatives and office functions such as staff training and recruiting.
  • Prioritize assignments and responsibilities to meet goals and deadlines.

Benefits

  • Tuition paid by BRG for certified coder certification course within the first 18 months of employment.
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