[Hiring] Healthcare Compliance Auditor @BRG

Remote Full-time
This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description The Healthcare Compliance Auditor position is a staff consulting position 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. β€’ Assessment of provider compliance programs β€’ Auditing of billing and coding of clinical documents and claims documents β€’ Execution of engagement work streams involving certified coding skills to audit provider claims and clinical documentation β€’ Focus on government programs such as Medicare and Medicaid β€’ Develop audit specifications and perform expert analysis of healthcare claims β€’ Quality control and development of client deliverables The work of a Consultant involves: β€’ Billing and coding audits β€’ Compliance program review β€’ Quality control β€’ Development of client deliverables β€’ Industry research The work of a Managing Consultant involves: β€’ Management of junior staff β€’ Quality control β€’ Development and presentation of client deliverables β€’ Industry research This specific position will require knowledge of medical coding and compliance, and potential candidates must have medical auditing expertise. Qualifications β€’ An undergraduate degree (e.g., BS, BA) β€’ Active coding certification from either AAPC or AHIMA is required β€’ Preference for candidates certified in medical auditing β€’ 2+ years of work experience with a focus on healthcare provider billing and coding; 5-7 years for Managing Consultant level β€’ Experience with physician practice coding (e.g. primary care, dermatology, orthopedics, ophthalmology), ASC coding, and/or post-acute coding (e.g. hospice, home health, SNFs) β€’ Comprehensive knowledge of Medicare rules, regulations, and guidelines β€’ Advanced knowledge of CPT-4, HCPCS, and ICD-10-CM coding systems Requirements β€’ Ability to interpret national coding and documentation guidelines β€’ Proficient user in Microsoft Office Suite, specifically Excel, PowerPoint, Access, and Word β€’ Commitment to producing high quality analysis and attention to detail β€’ Excellent time management and organizational skills β€’ Keen interest in healthcare compliance and healthcare policy β€’ Exceptional verbal and written communication skills β€’ Desire to work within a team environment β€’ Must be able to submit verification of legal right to work in the U.S., without company sponsorship Benefits β€’ Consultant Salary Range: $70,000 – $150,000 β€’ Managing Consultant Salary Range: $100,000 – $230,000
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