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Outpatient Revenue Consultant
2 months ago
Role: Outpatient Clinical Consultant
About Us:
Kaufman Hall & Associates LLC is dedicated to empowering essential sectors such as healthcare and education to reach their utmost capabilities in serving communities. With nearly four decades of experience, we stand as reliable advisors in dynamic environments, offering independent and objective insights that are firmly rooted in comprehensive data analysis.
Our Expertise:
We specialize in top-tier management consulting across various domains including Strategy & Business Transformation, Financial Planning & Data Analytics, Treasury & Capital Markets, Mergers & Acquisitions, and Revenue & Operations Improvement.
Job Responsibilities:
The Revenue & Operations Improvement team is seeking a Clinical Consultant with expertise in outpatient facility documentation, coding, and charging. The ideal candidate will collaborate with diverse hospital stakeholders to enhance processes, measurement tools, and resources aimed at accurately capturing outpatient revenue while ensuring compliance with industry standards. Key responsibilities include:
- Leading clinical and coding tasks throughout assessment, implementation, and monitoring phases of projects.
- Conducting reviews of retrospective claims, charge capture, and coding validations, alongside EMR documentation assessments.
- Evaluating medical records to ensure comprehensive and precise documentation that reflects patient acuity and resource utilization.
- Identifying areas for improvement in medical record documentation to accurately depict patient complexity and care provided.
- Engaging in team-based peer reviews of charts and claims.
- Documenting and finalizing findings from chart reviews for client communication.
- Delivering training and education on clinical documentation, coding, and charging guidelines through virtual and in-person formats.
- Collaborating with team members to ensure the specificity, accuracy, and completeness of clinical documentation, thereby upholding the integrity of medical records.
Qualifications:
The successful candidate will have a background in clinical practice, coding, revenue integrity, or clinical documentation improvement, with qualifications including:
- Clinical credentials: RN/BSN/MSN.
- Coding certifications: RHIT/RHIA/COC/CPC.
- Certifications in Revenue Integrity and Clinical Documentation: CHRI/CRIP/CCDS/CDEO.
- Familiarity with Charge Description Master (CDM) data.
- Strong written and verbal communication skills, with the ability to manage multiple projects effectively.
- Ability to work collaboratively with individuals from various disciplines.
- Demonstrated independence, sound judgment, and resourcefulness.
- Proven ability to build strong relationships with key stakeholders.
- Knowledge of regulatory compliance issues in the healthcare sector.
- Proficiency in Microsoft Office Suite, particularly Excel and PowerPoint.
- Willingness to travel for project assignments (up to 50%).
Education:
A minimum of an Associate's degree is required, with a preference for a Bachelor's or Master's degree from an accredited institution.
Work Environment:
This role involves approximately 50% travel and is primarily remote when not traveling. Work settings include a combination of home office and client locations, utilizing standard office equipment.
Kaufman Hall & Associates LLC is committed to fostering an inclusive workplace, ensuring equal opportunity for all employees and applicants without regard to any legally protected status.
