Briljent

Learning and Development

• Facilitate instructor-led training (in-person and virtual)
• Conduct knowledge transfer sessions and system walk-throughs
• Prepare for and deliver training by becoming proficient in technology and training materials
• Collaborate with Instructional Designers and client stakeholders to plan training schedules
• Provide feedback and recommended updates to training materials

Training Facilitator

Consultant

• Plan and implement solutions related to HIT and other innovations in health care administration
• Lead or assist with face-to-face meetings with clients to introduce Briljent services
• Provide assistance with the RFP response process as requested
• Facilitate action and change as appropriate to achieve project success
• Develop analytic and measurement strategy for all projects undertaken

Senior Consultant

Auditor

• Support medical record reviews, billing compliance audits for the Indiana Health Coverage Programs.
• Evaluate quality of care, reviewing medical records and program policies and identifying compliance issues.
• Prepare audit documentation and reports, and support appeals activities.
• Conduct medical record and compliance reviews independently and provide preliminary findings to the Lead Reviewer.
• Identify potential documentation deficiencies, and billing compliance issues.
• Maintain detailed workpapers documenting procedures performed, records reviewed, findings identified, and conclusions reached.
• Assist with audit responses and appeals as needed.
• Ensure all work aligns with state, federal, and national healthcare and Medicaid guidelines.

Clinical Auditor, RN

IT Support

• Review medical records and related documentation to assess coding accuracy and compliance with Indiana Health Coverage Programs, CMS, AMA, and other applicable standards and regulations
• Conduct coding and documentation reviews independently and provide preliminary findings to the Lead Reviewer
• Identify potential coding discrepancies, documentation deficiencies, and billing compliance issues
• Maintain detailed workpapers documenting procedures performed, records reviewed, findings identified, and conclusions reached
• Assist with audit responses and appeals as needed
• Ensure all work aligns with state, federal, and national coding and reimbursement guidelines
• Stay current on CPT, HCPCS, ICD-10-CM, and Medicaid coding guidelines, policies, and regulatory updates
• Research Indiana Medicaid rules and maintain internal repositories of bulletins, policies, and procedures
• Adapt quickly to changing priorities, policies, regulatory updates, and review requirements while maintaining accuracy and meeting deadlines

Medical Coder – Audit Specialist

QA Engineer

• Design, automate, and execute test strategies ensuring accuracy and reliability of healthcare data
• Review Change Requests (CRs) and participate in requirement analysis for new EDW extracts and transformations.
• Perform backend testing to compare data from source systems to target Medicaid EDW tables.
• Write and execute complex SQL queries (multi-table joins, aggregations, validations).
• Design and maintain ETL test plans, scenarios, and test cases.

Training Facilitator

Senior Consultant

Clinical Auditor, RN

Medical Coder – Audit Specialist

Quality Assurance Analyst, ETL Tester