Managing Consultant - Healthcare Performance Improvement (Revenue Integrity)

BRG • Washington, DC

75d • $70,000 - $150,000 • Remote

About The Position

We do Consulting Differently BRG’s Healthcare Performance Improvement (HPI) practice works with healthcare providers to identify and implement measurable and sustainable financial, clinical, and operational performance improvements. We combine comprehensive expertise, experience, and analytics to deliver data-driven, innovative approaches to help hospitals, health systems, academic medical centers, and other providers tackle their most complex problems. We have assessed and implemented nearly $1 billion in cost savings and revenue improvement for our diverse set of clients over the last ten years. The HPI Revenue Cycle team is currently seeking either a Senior Associate or 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. An individual with an entrepreneurial spirit and an ability to apply creative solutions is a natural fit for this position. The work of a Senior Associate/Consultant will involve both execution and oversight of engagement work stream initiatives that may be either qualitative or quantitative in nature, and responsibilities include: design of financial analysis, development and presentation of client deliverables, management of existing client relationships, industry research, and expansion of business. Job title and compensation to be determined based on qualifications and experience.

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.
• 2-6 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
• Willing to travel consistently (50% - 75%, depending on project requirements and client expectations) is required for this position.
• Candidate must be able to submit verification of his/her legal right to work in the U.S., without company sponsorship.

Nice To Haves

• 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)

Responsibilities

• 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

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Number of Employees: 1,001-5,000 employees