Job Description

Ankura is a team of excellence founded on innovation and growth.

Practice Overview

Ankuras Health Care Disputes, Compliance and Investigations practice advises outside counsel and their clients on a wide variety of legal and regulatory matters. Our practitioners provide expert witness testimony on commercial disputes involving payers and providers, as well as in matters involving False Claims Act, Anti-kickback, Stark, and FDA disputes and investigations. We work with Chief Compliance Officers to build and mature their compliance programs, conduct program effectiveness reviews, and risk assessments, and perform compliance audits. We assist in-house and outside counsel during internal and externally driven investigations through the evaluation of medical records, the determination of medical necessity and appropriate medical coding, and the computation of financial impacts that may lead to repayments. We also provide investigative assistance in matters involving research misconduct, human subjects protection, and financial fraud related to research. Our practice is often called upon to advise investors on operational and compliance matters during due diligence. We serve as the Independent Review Organization for many clients and our work product is routinely presented to the Office of Inspector General of HHS and the US Department of Justice. We also work on provider / payor litigation matters where our team members serve as experts. Our clients include academic medical centers, health systems, physician practice groups, post- and sub-acute providers, health plans, pharmacies, and pharmacy benefit management companies, as well as pharmaceutical and medical device manufacturers.

Responsibilities:

Proficient in medical coding, billing, and documentation requirements

Works with Project Managers to analyze and understand client concerns and develop project work plans as requested

Understands health care compliance concepts, issues, and how to research and access regulatory guidelines and reference materials

Conducts independent review of medical records EMR (electronic medical records) or paper documentation

Drafts clear and concise analyses of medical record review and coding findings

Ensures successful completion of high-quality project deliverables as assigned and within the desired timeframe

Works collaboratively with Ankura team members focusing on building and maintaining internal and external client and counsel relationships

Proven writing and presentation skills and has a keen sense of attention to detail

Communicates findings of concern with the team and Project Manager as they are identified

Utilizes creative and critical thinking problem-solving techniques

Qualifications:

Bachelors degree in HIM (health information management) from an accredited college/university

Certified in health care coding (CPC) inpatient, outpatient, and professional services

Experience in an HIM role (supervisory preferred) related to clinical documentation, compliance, or coding of medical services

Familiar with the revenue cycle process and facility and professional claims

Demonstrates excellent communication skills, both written and oral

Experience managing small projects and teams

Familiar with accessing and identifying clinical documentation in electronic medical record systems

Proficient in Excel, Word, and PowerPoint and able to draft reports and presentations and present findings

Ability to problem solve, multi-task, and prioritize assignments

Understands the importance of privileged and confidential communication

Willingness to travel when needed

Must be legally authorized to work in the United States without the need for employer sponsorship, now or at any time in the future.

#LI-EN1

#LI-Remote

Ankura is an Affirmative Action and Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, or protected veteran status and will not be discriminated against based on disability. Equal Employment Opportunity Posters, if you have a disability and believe you need a reasonable accommodation to search for a job opening, submit an online application, or participate in an interview/assessment, please email accommodations@ankura.com or call toll-free +1.312-583-2122. This email and phone number are created exclusively to assist disabled job seekers whose disability prevents them from being able to apply online. Only messages left for this purpose will be returned. Messages left for other purposes, such as following up on an application or technical issues unrelated to a disability, will not receive a response.

Ankura Consulting Group, LLC is an independent global expert services and advisory firm that delivers services and end-to-end solutions to help clients at critical inflection points related to conflict, crisis, performance, risk, strategy, and transformation. The Ankura team consists of more than 1,800 professionals serving 3,000+ clients across 55 countries who are leaders in their respective fields and areas of expertise. Collaborative Lateral Thinking That Delivers??, hard-earned experience, expertise, and multidisciplinary capabilities drive results and Ankura is unrivalled in its ability to assist clients to Protect, Create, and Recover Value??. For more information, please visit, ankura.com.

Job Tags

Similar Jobs