Managing Consultant - Revenue Integrity - Healthcare

BRG

1d • $120,000 - $165,000 • Remote

About The Position

The Integrated Health Solutions (IHS) practice at Berkeley Research Group (BRG) provides end-to-end advisory support to healthcare providers, payers, investors, and other stakeholders navigating complex strategic, operational, financial, and clinical challenges. Led by seasoned healthcare executives, operators, and clinicians, IHS partners with organizations to drive sustainable performance improvement and long-term growth through strategic growth design, operating model transformation, AI and digital enablement, clinical quality and patient care optimization, and revenue strategy—helping clients build resilient, future-ready healthcare enterprises in an increasingly complex environment. Our four core service offerings include: • Business Transformation Advisory • Margin & Operational Improvement • Clinical & Quality Transformation • AI & Digital Solutions Margin & Operational Improvement drives measurable financial improvement by providing clients with comprehensive solutions designed to increase revenue, optimizing cost containment strategies. This division utilizes innovative approaches to transform operating models and deliver true sustainable margin improvement. Our team of operation leaders, business analysists and deep subjects matter experts focus on implementing solutions around the following focus areas: • Workforce productivity and Human Resources • Supply chain and Corporate Overhead performance • Revenue Cycle effectiveness • Managed care, Revenue Integrity and Pricing Strategies • Ambulatory Operations and Physician Enterprise The Revenue Cycle team is currently seeking a Managing 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 Managing 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. Willing to travel consistently (50% - 75%), depending on project requirements and client expectations, is required for this position.

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
• 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

Benefits

• BRG is proud to be an Equal Opportunity Employer. Our hiring practices provide equal opportunity for employment without regard to race, religion, color, sex, gender, national origin, age, United States military veteran status, ancestry, sexual orientation, marital status, family structure, medical condition including genetic characteristics or information, veteran status, or mental or physical disability so long as the essential functions of the job can be performed with or without reasonable accommodation, or any other protected category under federal, state, or local law.
• If you need reasonable accommodation for any part of the employment process, please contact us by email at [email protected] and let us know the nature of your request and your contact information. Requests for Website Accessibility and Required Information for Online Applicant Tracking Systems accommodation will be considered on a case-by-case basis. Please note that only inquiries concerning a request for reasonable accommodation will be responded to from this email address.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level