The Revenue Integrity team is currently seeking a Senior 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 Senior 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.
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
Qualifications
• 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.
• 7+ 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. Job title and compensation to be determined based on qualifications and experience.
• 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)
Senior Managing Consultant Salary Range: $166,000 - $199,000 per year
Job title and compensation to be determined based on qualifications and experience.
Candidate must be able to submit verification of his/her legal right to work in the U.S., without the need for company sponsorship now or in the future.
