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Senior Associate - Healthcare Transaction Strategy (Compliance)

Location: , United States
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Description

The Senior Associate 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. 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 Senior Associate will involve execution of engagement work streams that will primarily involve employing certified coding skills to audit provider claims and provider clinical documentation with a particular focus on government programs such as Medicare and Medicaid. Responsibilities include working with team to develop audit specifications, expert analysis of healthcare claims and supporting documentation, quality control, and development of client deliverables. 
 
This position requires a highly motivated problem solver with strong analytical ability and a desire to advance within the organization. The work of a Senior Associate can be either qualitative or quantitative in nature, and projects range from industry and subject-matter research to data collection to the preparation of statistical, financial, and other forms of analysis. 
 
This specific position will require knowledge of medical coding and compliance and potential candidates must have medical auditing expertise. Job title and compensation to be determined based on qualifications and experience. 
 
Responsibilities 
  • Provide support on all aspects of small to medium sized client engagements and discreet portions of larger projects. Example engagements include compliance program effectiveness reviews, enterprise-wide risk assessments, compliance program development, and preparation and delivery of employee compliance training.
  • Prepare requests for information for documentation related to a practice or facility compliance program.
  • Review compliance-related documentation including policies and procedures, compliance manuals, job descriptions, training plans and materials, incident logs, and payer audit correspondence.
  • Create interview agendas for practice personnel with compliance responsibilities.
  • Participate in interviews with practice management.
  • Apply appropriate methodology to assignments informed by federal and state regulatory and enforcement agencies' guidance including the US Department of Justice’s (DOJ) Evaluation of Corporate Compliance Programs, the US Department of Health and Human Services Office of the Inspector General’s (OIG) Compliance Program Guidance and State-specific guidance, as applicable.
  • Assist with the creation of program documentation including policies and procedures, training materials, and audit workplans.
  • Provide valuable contributions to client deliverables including summaries of findings, gap analyses, and recommendations for improvement.
  • Utilize relevant tools such as the Microsoft Office Suite (Word, PowerPoint, Excel) to document work product and prepare deliverables.
  • Review own work and work of the engagement team to ensure quality.
  • Communicate effectively both orally and in writing.
  • Adapt to shifting priorities and demonstrate ability to contribute to multiple engagements simultaneously.
  • Demonstrate a strong work ethic to meet client deadlines and quality expectations. 
 Qualifications  
  • A bachelor’s or master’s degree (e.g., BS, BA, MBA, MHA, MPH, etc.) with a preferred focus in Healthcare Administration, Business Administration, Health Policy & Management, or related discipline.
  • 2-4 years of prior work experience with a focus on healthcare compliance
  • Applicable industry certification is preferred (e.g., CHC, CPCO, CHPC, etc.).
  • Knowledge and understanding of the OIG’s Compliance Program Guidance documents.
  • Preferred expertise in any one of the following areas: revenue cycle management, medical coding, HIPAA privacy and security, CMS Conditions of Participation (CoPs) and Conditions for Coverage (CfCs).
  • Excellent interpersonal skills with the ability to effectively manage team and client relationships.
  • Strong verbal and written communication and presentation skills.
  • Exceptional time management, organizational skills, and ability to prioritize work and meet deadlines.
  • Ability to succeed in a high-performance and rapid team environment.
  • Strong proficiency in MS Office applications, including Word, PowerPoint, Excel, Access, and Outlook.
  • Keen interest in healthcare compliance and healthcare policy. 
Candidate must be able to submit verification of their legal right to work in the U.S., without company sponsorship.
 
Salary Range: $70,000 – $135,000
 
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