Thinkbrg
Consultant - Healthcare Compliance Auditor - HTS
Remote - USA
Work authorization required$70k-$150kDetected 31 days ago
Data AnalysisComplianceBusiness DevelopmentExcelAuditingICD-10CommunicationTime ManagementOrganizational SkillsMicrosoft Office
About the role
- We do Consulting Differently The Healthcare Compliance Auditor position is a staff consulting position within the Healthcare Transactions and Strategy (HTS) group.
- HTS is currently seeking a Healthcare Compliance Auditor at the Consultant level.
- This position requires a highly motivated problem solver with strong analytical ability, solid organizational skills, and a desire to advance within the organization.
Responsibilities
- Develop coding and documentation audit methodology using knowledge of key risk areas in coding and documentation compliance
- Develop analyses using transactional data and/or financial data
- Demonstrate creativity and efficient use of relevant software tools and analytical methods to develop solutions
Requirements
- 4-year degree (BS or BA)
- Active coding certification from either AAPC (CPC, CPMA) or AHIMA (CCC-P, AOC) is required
- Advanced knowledge of CPT-4, HCPCS, and ICD-10-CM coding systems, guidelines, and regulatory requirements.
- Required skills include:
- Demonstrated ability to interpret national coding and documentation guidelines and translate them into effective auditing practices and tools
- A desire to expand those capabilities is required, as is the ability to train others to use such tools.
- Excellent time management, organizational skills, and ability to prioritize work and meet deadlines.
- Candidate must be able to submit verification of their legal right to work in the U.S., without company sponsorship.
- Candidate must be able to submit verification of legal right to work in the U.S., without company sponsorship.
- BRG combines world-leading academic credentials with world-tested business expertise and purpose-built emerging technologies.
- Do not desire risk adjustment certifications (CRC, RAC) or experience. Do not desire inpatient hospital certifications (CIC, CCS) or experience.
- Preference will be given to candidates that are certified in medical auditing.
- 2+ years of work experience with a focus on healthcare provider billing and coding
- Preference will be given to candidates that are experienced with physician practice coding (e.g. primary care, dermatology, orthopedics, ophthalmology), ASC coding, and/or post-acute coding (e.g. hospice, home health, SNFs).
- Preference will be given to candidates that have previously worked in a consulting firm environment in which their duties included auditing providers or providing audits associated with transactional diligence.
- Preference will be given to candidates who have worked in a role at a health plan auditing and reviewing providers in that plan's network.
- Comprehensive knowledge of Medicare rules, regulations, and guidelines as they apply to coverage, coding, and provider documentation.
- identify issues in coding and documentation practices and recommend corrective action
Nice to have
- Less than 10 years preferred.
Compensation
- $70,000 - $150,000
Benefits
- include working with team to develop audit specifications, expert analysis of healthcare claims and supporting documentation, quality control, and development of client deliverables.
- This specific position will require knowledge of medical coding and compliance, and potential candidates must have medical auditing expertise.
- Plan and perform medical record audits to determine coding accuracy and compliant claims submission.
Equal opportunity
- BRG is proud to be an Equal Opportunity Employer.
Visa & Work Authorization
- Candidate must be able to submit verification of their legal right to work in the U.S., without company sponsorship.
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