Senior Associate - Healthcare Compliance Analyst - HTS

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The Healthcare Compliance Analyst position is a staff consulting position within the Healthcare Transactions and Strategy (HTS) group. HTS is currently seeking a Healthcare Compliance Analyst at the Associate or Senior Associate level.

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. The work of a Healthcare Compliance Analyst will involve execution of engagement work streams that will primarily involve supporting the compliance team as the team audits provider claims and provider clinical documentation with a particular focus on government programs such as Medicare and Medicaid. Responsibilities include working with team to manage and organize document intake, research coverage policies, research target companies and relevant healthcare sectors, and support the development of client deliverables and client presentations.

The work of an Analyst involves execution of engagement work streams that may be either qualitative or quantitative in nature, and responsibilities include: coding and coverage research, writing, use of excel, quality control, development of client deliverables, and industry research.

This specific position will require knowledge of healthcare sector and a strong interest in healthcare compliance.  Candidate will be expected to obtain coding certifications (e.g. CPC) while employed.   Job duties will include certified coder certification course within the first 18 months of employment with tuition paid by BRG.  Job title and compensation to be determined based on qualifications and experience.
 

Job Responsibilities:

• Support medical record audits to determine coding accuracy and compliant claims submission with research and document management.
• Assist with coding and documentation audit methodology including writing PowerPoint slides and compiling Excel spreadsheets under the direction of more senior auditors.
• 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.
• Actively pursue and obtain coding certifications (e.g. CPC) in order to advance to higher job positions as an auditor preforming full audit duties.
• 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.
• Participate in group practice meetings, contribute to business development initiatives and office functions such as staff training and recruiting.
• Prioritize assignments and responsibilities to meet goals and deadlines.
   

Qualifications:

• 4-year undergraduate degree (e.g., BS, BA).
• Preference will be given to candidates that are certified in medical auditing.
• 0 to 2 years of work experience with a demonstrated interest in healthcare industry and healthcare provider billing and coding compliance.
• Preference will be given to candidates with undergraduate academic studies that demonstrate an interest in healthcare sector and healthcare administration and management.
• Work experience related to healthcare coding, billing and compliance or healthcare administration and management further enhances an applicant.
   

Required skills include:

• Ability to research national coding and documentation guidelines; knowledge of healthcare sector and healthcare payment systems, and to 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.
   

Associate Salary Range: $70,000 – $90,000 per year.

Senior Associate Salary Range: $85,000 – $115,000 per year.

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

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 interdisciplinary relationships that give us the edge, laying the groundwork for more informed insights and more original, incisive thinking.  When paired with our global reach and resources, our diverse perspectives and technical capabilities make us uniquely capable to address our clients’ challenges. We get results because we know how to apply our thinking to your world.

At BRG, we don’t just show you what’s possible. We’re built to help you make it happen. 

BRG is proud to be an Equal Opportunity Employer. Our hiring practices provide equal opportunity for employment without regard to race, religion, color, sex, gender, national origin, age, United States military veteran status, ancestry, sexual orientation, marital status, family structure, medical condition including genetic characteristics or information, veteran status, or mental or physical disability so long as the essential functions of the job can be performed with or without reasonable accommodation, or any other protected category under federal, state, or local law.