Data Quality & Compliance Consultant
Founded in 1989, and located in Fenton,
Michigan, our client provides quality
service and assistance
to healthcare management. Their highly experienced team of dedicated
professionals work with clients to assist them in maintaining corporate
financial viability through compliant, efficient business operations.
Since its conception, healthcare organizations have relied on the experienced
professionals at our clients company for advice. Their knowledgeable staff
holds a diverse background of healthcare, clinical, and financial management
In today’s fiercely competitive healthcare environment, innovative ideas are
crucial to any organization’s success. With a focus on recognizing
opportunities and capitalizing on trends, their consultants will suggest strategies
that can assist in complying with the myriad of third-party regulations, while
ensuring that people are paid accurately for the services that the company
Our client places their clients’ interests first because they know that they
cannot succeed unless the clients do. This organization’s approach to every
project is to strive for client success and satisfaction above all.
Proven Track Record:
Our client is proud of their reputation for excellence, which is evident
through years of successful service and positive client feedback. This
reputation speaks for itself.
Today’s healthcare providers are faced
with complex business challenges. As the urgency to increase cash flow mounts
and the pressure to improve the bottom line grows, the challenge is greater
than ever before. Our client has designed services to assist you in navigating
the complicated maze of payment regulations.
Their services include:
Blue Cross Payment Services
Cost Report Reimbursement Services
Critical Access Hospitals
Inpatient Focused Services
Low Volume Adjustment
Medicare Disproportionate Share Hospital Payment
Outpatient Focused Services
Payment Transaction Analysis and Optimization
Recovery Audit Contractor Reviews
Reimbursement and Payment
Rural Health Issues
Job Title: Data Quality &
Reports To: Director of Data Quality
FLSA Status: Exempt
Performed By: TBD
Responsible for working
as a consultant in relation to coding for facility and professional
include but not limited to compliance, chart audits, charge and
reviews, charge capture assessments, revenue cycle engagements, data analyses,
education and other duties as assigned.
4-6 years of directly related
Bachelor degree in related area, or
RHIT, RHIA, or CPC certification
Strong understanding of the outpatient
hospital reimbursement process, including the documentation, coding, and
billing of services, as well as denials management and components of the
revenue cycle. Professional reimbursement knowledge a plus.
Strong analytical capability,
independent thinker and good decision making skills
Proven team player able to work in a
Excellent project management,
organizational and interpersonal skills, ability to prioritize workload
Ability to work with senior executives
and business partners
Excellent written and verbal
communication and presentation skills
Strong computer and technology
knowledge and skills
Exemplary client satisfaction skills
Ability to process industry information to develop value added client
Responsible to provide consultant services, administrative direction,
leadership and oversight for outpatient hospital and professional related
services. This includes overseeing, coordination and active participation in
all data quality & compliance related projects ( quality reviews,
chargemaster reviews, data assessments, denials management, education, etc.).
Primary focus areas will be determined based on experience and the needs of the
Active involvement in marketing efforts of identified services to
current and prospective clients. This includes working with the Director of
Client Services and Business Development to identify needs, the development of
an action plan and identification of additional engagement opportunities
through review work.
Compile, analyze, and evaluate medical record data to identify areas
where clinical documentation can be enhanced for outpatient hospital and
professional services. Identify opportunities for more appropriate
reimbursement and provide education regarding.
Responsible for developing relationships with clients and prospective
clients to generate billable projects. Consult with clients/prospective clients
to ascertain and define needs or problem areas, and determine the scope of investigation
required to obtain a solution.
Responsible for service development and strategic planning related to
facility and professional services. Includes the identification and development
of new services in relation to market changes.
Develop and maintain benchmark information based on findings from
reviews. Utilize this information in the report process and marketing efforts.
Provide presentations to clients, prospective clients, and associations
Develop and maintain a high level of expertise in performing of and
meeting engagement objectives.
Serve as coordinating consultant and client contact for various
Make self available to answer client calls, researching issues as
Maintain active membership in appropriate association ( s) to promote
professional interaction with peers and perception of "expertise" in
coding activities. Includes activity on relevant committee.
Develop and maintain the skills and knowledge necessary related to the
assigned specialty areas and the related services. Keep current on all related
information from journals and bulletins. Distribute and pass on all necessary
materials, including copying for reference files when relevant.
Maintain current certifications and accreditations ( as applicable).
Work to identify ways to streamline current processes to improve the
efficiency and profitability of the engagements.
Maintain a minimum billability rate of 75%, dedicating this time to
direct client duties. 25% or less time should be associated with planning,
development, marketing and other functions.
Travel onsite to clients as necessary. Includes day travel and overnight
stays. Approximate 15%-30%.
Other duties may be assigned as necessary.
Compensation: $125K + base
Reaction Search International - 12 months ago
RSI's Healthcare Executive Search Firm Specialty Practice specializes in the recruitment of Healthcare professionals and executives.