Berkeley Research Group delivers expert consulting services and strategic advisory services for large corporations, financial institutions, regulatory bodies, a
Managing Consultant – Revenue Integrity, Healthcare
Location
United States
Posted
10 days ago
Salary
$120K - $165K / year
Seniority
Senior
Job Description
Managing Consultant – Revenue Integrity, Healthcare
Berkeley Research Group
• 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.
Job 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
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