Outpatient Clinical Consultant
The Organization
We help society’s foundational institutions—healthcare and higher education—to achieve their full potential in service to others.
We are our clients’ trusted partners in ever-changing times. For nearly 40 years, Kaufman Hall has provided independent, objective insights grounded in sound data and analysis to help clients fulfill their missions, achieve their goals, and tackle their toughest problems.
Kaufman Hall provides world-class management consulting in Strategy & Business Transformation, Financial Planning & Data Analytics, Treasury & Capital Markets, Mergers & Acquisitions, Revenue & Operations Improvement (previously Performance Improvement).
At Kaufman Hall, we believe that sustained success is never an accident. It is the result of sound decision making, based on data-driven analysis and disciplined thinking, and guided by the fundamental principles of corporate finance.
The Position
The Claro Healthcare practice is looking for a Clinical Consultant with outpatient facility documentation, coding, and/or charging experience integrated with the knowledge and experience of teaming with various hospital stakeholders to improve processes, measurement tools, and resources for the accurate capture of outpatient revenue and compliance with industry rules and regulations. Heavy involvement and role in overall client interaction and satisfaction. Partner with clients in all phases of Outpatient CDI and charging engagements to assist them to succeed. Participate in multiple engagements with strong teamwork and time management required. Must have deep understanding and contributions for outpatient facility documentation, coding, and/or charging. These contributions need to be definable and illustrate value. Great benefit package and bonus incentives. Specific responsibilities include:
- Leading clinical/coding focused tasks during assessment, implementation, and monitoring phases of projects
- Reviewing retrospective claims, conducting charge capture and coding reviews/validations, and reviewing/validating EMR documentation
- Reviewing medical records for complete and accurate documentation to reflect the severity of illness and resources used
- Identifying opportunities for improved documentation in the medical record to more accurately reflect the acuity and complexity of the patient and the care provided
- Participating in team-based peer chart and claims reviews
- Writing, editing and finalizing chart review findings that are shared with our clients
- Performing clinical documentation, coding and charging guideline training/education via virtual and/or in-person presentations and department discussions
- Working collaboratively with team members to achieve overall specificity, accuracy, and completeness of clinical documentation to support the highest integrity of the medical record
The ideal candidate will possess:
- Clinical experiences including RN/BSN/MSN is highly desired
- One or more RHIT, RHIA, COC, CPC, CHRI, and/or CCDS certifications are recommended, but not required
- Three or more years of experience in a consulting/professional services setting or provider healthcare setting with focus on healthcare revenue integrity/outpatient facility documentation, coding, and/or charging and related issues is strongly preferred
- Understanding of Charge Description Master (CDM) data
- Demonstrated written and verbal communication skills and the ability to manage and prioritize multiple projects
- Ability to team effectively with people of various disciplines and backgrounds is essential
- Demonstrated ability to work independently, exercise good judgment, and be resourceful
- Demonstrated ability for developing strong working relationships with key stakeholders and/or clients
- Experience/knowledge of regulatory compliance issues facing the healthcare industry
- Microsoft suite of business software, specifically Excel and PowerPoint
- Ability to travel regularly for project assignments is required (up to 50% travel)
- This role requires a fair amount of client travel. At the present time, the majority of Claro Healthcare's clients require onsite visitors to be fully vaccinated against COVID-19
- Applicants for employment must have work authorization that does not now or in the future require sponsorship of a visa for employment authorization in the United States and with Kaufman Hall (i.e., H1-B visa, F-1 visa (OPT), TN visa or any other non-immigrant status)
- Associate’s degree required. Bachelor’s or master’s degree from an accredited college/university is preferred
- Must be able to perform essential duties satisfactorily with reasonable accommodations
- Work is generally done sitting, talking, hearing and typing. Visual acuity to use a keyboard, prepare and analyze data and figures; transcribing, viewing a computer terminal; extensive reading
- Travel Required: Approximately 50%
- The role is remotely based
- Work is regularly performed in a combination of home office and client settings and routinely uses standard office equipment
- It may require the maintenance of a home office and proximity to an airport for work-related travel
Kaufman Hall is committed to providing equal opportunity for all employees and applicants. We recruit, hire, train, promote, pay, and administer all employment actions without regard to actual and also perceived or assumed protected group status as defined by law of an individual or that individual’s associates or relatives. Our policies and the law prohibit employment discrimination against any employee or applicant on the basis of any legally protected status.
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