Associate / Senior Associate - HTS

Berkeley Research Group; United States; On-site; USD 70,000 - 115,000; Full time

Job summary

Berkeley Research Group (BRG) invites a Healthcare Compliance Auditor to join the HTS group in the United States. You will conduct medical record audits, develop auditing methodologies, and deliver client-ready reports while staying current on coding guidelines and industry developments.

The role starts at Associate or Senior Associate level, with training to obtain AAPC or AHIMA certifications. Strong analytical skills and teamwork are essential to succeed in regulatory, reimbursement, and data

Qualifications

• 4-year degree (BS/BA) and healthcare interest.
• 1–2 years' professional experience in consulting or healthcare.
• Desire to obtain medical coding certification.

Responsibilities

• Plan and perform medical record audits to determine coding accuracy and compliant claims submission.
• Develop coding and documentation audit methodology using knowledge of key risk areas in coding and documentation.
• Perform coding and documentation audits, reviewing medical records and charges to ensure compliance.
• Conduct analysis of audit findings to identify trends/problems in coding and documentation and effectively communicates the audit findings and recommended areas for improvement.
• Monitor relevant resources, publications, and current government compliance and enforcement activity related to high-risk compliance areas.
• Learn and stay current on coding guidelines.
• Develop analyses using transactional data and/or financial data.
• Generate client deliverables and make valuable contributions to expert reports.
• Demonstrate creativity and efficient use of relevant software tools and analytical methods to develop solutions.
• Prioritize assignments and responsibilities to meet goals and deadlines.

Skills

Analytical thinking

Attention to detail

Time management

Communication skills

Team collaboration

Education

Bachelor's degree (BS/BA)

Tools

Microsoft Excel

Microsoft PowerPoint

Access

Word

Job description

We Do Consulting Differently

Are you a graduate from a top-tier university looking to break into the rapidly growing healthcare sector? We are seeking a highly analytical, detail-oriented individual with a deep passion for healthcare to join our team. We will provide comprehensive training for your AAPC (CPC, CPMA) or AHIMA (CCC-P, AOC) certification. This position is a launchpad for a high-growth career in healthcare consulting!

We are looking to make you into a great Healthcare Compliance Auditor within the Healthcare Transactions and Strategy (HTS) group. HTS performs regulatory, reimbursement, data analytics, and compliance auditing for healthcare providers, healthcare payers and healthcare investors. Compliance audit deliverables include assessment of provider compliance programs and auditing of billing and coding of clinical documents and claims documents. This position requires a highly motivated problem solver with strong analytical ability, solid organizational skills, and a desire to advance within the organization.

Your career will start at the Associate or Senior Associate level. The work involves execution of engagement work streams that may be either qualitative or quantitative in nature, and responsibilities include: billing and coding audits, compliance program review, quality control, development of client deliverables, and industry research.

Job Responsibilities:

• Plan and perform medical record audits to determine coding accuracy and compliant claims submission.
• Develop coding and documentation audit methodology using knowledge of key risk areas in coding and documentation compliance.
• Perform coding and documentation audits, reviewing medical records and charges to ensure compliance.
• Conduct analysis of audit findings to identify trends/problems in coding and documentation and effectively communicates the audit findings and recommended areas for improvement.
• Monitor relevant resources, publications, and current government compliance and enforcement activity related to high-risk compliance areas
• Learn and stay current on coding guidelines.
• Develop analyses using transactional data and/or financial data.
• Generate client deliverables and make valuable contributions to expert reports.
• Demonstrate creativity and efficient use of relevant software tools and analytical methods to develop solutions.
• Prioritize assignments and responsibilities to meet goals and deadlines.

Qualifications:

• 4-year degree (BS or BA), a passion for healthcare, and a desire to get a medical coding certificate.
• Preference will be given to candidates that are certified in medical auditing.
• 1-2 years of work experience in a professional setting ideally in consulting with a focus on healthcare.
• 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.

Required skills include:

• A desire and ability to interpret national coding and documentation guidelines and translate them into effective auditing practices and tools; identify issues in coding and documentation practices and recommend corrective action; develop reports, track, and trend audit findings and results.
• Proficient user in Microsoft Office Suite, specifically Excel, PowerPoint, Access, and Word. A desire to expand those capabilities is required, as is the ability to train others to use such tools.
• Commitment to producing high-quality analysis and attention to detail.
• Excellent time management, organizational skills, and ability to prioritize work and meet deadlines.
• Keen interest in healthcare compliance and healthcare policy.
• Exceptional verbal and written communication skills.
• Desire to work within a team environment.

Salary Range: $70,000 - $115,000

Candidate must be able to submit verification of legal right to work in the U.S., without company sponsorship now or in the future.

About BRG

BRG combines world-leading academic credentials with world-tested business expertise and purpose-built emerging technologies. Our culture centers on agility and connectivity which sets us apart and gets you ahead.

At BRG, our professionals include specialist consultants, industry experts, renowned academics, and leading-edge data scientists. Together, they bring a diversity of real-world experience, data, and human and artificial intelligence, to economics, disputes, and investigations; corporate finance; and performance improvement services that address the most complex challenges facing organizations across the globe.

Our unique structure nurtures the interdi