BRG

Consultant – Healthcare Performance Improvement, Revenue Integrity

BRG

full-time

Posted on:

Location Type: Remote

Location: Remote • 🇺🇸 United States

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Salary

💰 $70,000 - $150,000 per year

Job Level

JuniorMid-Level

About the role

  • 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.

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.
  • 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).
  • 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.
Benefits
  • Health insurance
  • Flexible work hours
  • Professional development opportunities

Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard skills
charge generationcharge capturerevenue managementfinancial modelingdata analysisprocess improvementdocumentation improvementcharge reconciliationcompliance principlesregulatory changes
Soft skills
communication skillspresentation skillscollaborationcreativityorganizational skillsprioritizationteamworkproblem-solvinganalytical thinkingfacilitation
Certifications
RHIARHITCPCCOCCCSCRIPAHIMA certificationAAPC certificationAAHAM certificationMBA
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