Senior Director, Health Care Disputes (Coding & Compliance)

Ankura

1d • Remote

About The Position

Ankura is a team of excellence founded on innovation and growth. Ankura’s Health Care Disputes and Life Sciences Practice advise outside counsel and their clients on a wide variety of legal and regulatory matters. Our practitioners provide expert witness testimony on commercial disputes involving payers and providers, as well as in matters involving False Claims Act, Anti-kickback, Stark, and FDA disputes and investigations. We work with Chief Compliance Officers to build and mature their compliance programs, conduct program effectiveness reviews, and risk assessments, and perform compliance audits. We assist in-house and outside counsel during internal and externally driven investigations through the evaluation of medical records, the determination of medical necessity and appropriate medical coding, and the computation of financial impacts that may lead to repayments. We also provide investigative assistance in matters involving research misconduct, human subject’s protection, and financial fraud related to research. Our practice is often called upon to advise investors on operational and compliance matters in the course of due diligence. We serve as the Independent Review Organization for many clients and our work product is routinely presented to the Office of Inspector General of HHS and the US Department of Justice. Our clients include academic medical centers, health systems, physician practice groups, post- and sub-acute providers, health plans, pharmacies, and pharmacy benefit management companies, as well as pharmaceutical and medical device manufacturers. This role is location agnostic and may be remote.

Requirements

• Current Coding Certification through either AAPC or AHIMA
• Minimum 10 years health care experience related to clinical documentation, compliance, or coding of medical services
• Demonstrates excellent communication skills, both written and oral
• Experience managing small projects and teams
• Familiar with accessing and identifying clinical documentation in electronic medical record systems
• Proficient in Excel, Word, and PowerPoint and able to draft reports and presentations and present findings
• Ability to problem solve, multi-task, and prioritize assignments
• Understands the importance of privileged and confidential communication
• Willingness to travel when needed

Nice To Haves

• Associate or bachelor’s degree preferred from an accredited college/university
• Clinical experience is a plus

Responsibilities

• Proficient in medical coding, billing, and documentation requirements
• Works with the Project Manager to analyze and understand client concerns and develop project work plans as requested
• Understands health care compliance concepts, issues, and how to research and access regulatory guidelines and reference materials
• Conducts independent review of medical records - EMR or paper documentation
• Drafts clear and concise analyses of medical record review findings
• Ensures successful completion of high-quality project deliverables as assigned and within the desired timeframe
• Works collaboratively with Ankura team members focusing on building and maintaining internal and external client and counsel relationships
• Proven writing and presentation skills
• Communicates findings of concern with the team and Project Manager as they are identified
• Utilizes creative problem-solving techniques

Benefits

• Ankura is an Affirmative Action and Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, or protected veteran status and will not be discriminated against based on disability.

What This Job Offers

• Job Type: Full-time
• Career Level: Senior
• Education Level: Associate degree
• Number of Employees: 501-1,000 employees