About the Role

We provide innovative solutions that optimize performance in the short term and prepare for future strategic, operational, financial and legal challenges unique to our healthcare and life sciences clients.

We help our clients improve the completeness and specificity of clinical documentation and coding through data analytics, benchmarking, and chart reviews. We identify and assist with implementation of documentation, coding, case management/utilization review, and HIM process enhancements to help our clients achieve compliant results. Our Directors work within diverse teams of professionals that include experienced nurse reviewers, other coding professionals, and physicians in reviewing medical records to independently evaluate the services provided and compliance with various regulations. Reviews may focus on particular coding issues, medical necessity, or clinical documentation improvement. Directors are asked to review medical records, document their findings and rationale for decisions and discuss them with project management, client and counsel. These reviews are based on regulatory guidance or industry standards, such as InterQual or MCG screening criteria.

What You'll Do

• Responsible for examining inpatient and post-acute medical records.
• Ensures that patient records support the appropriate clinical severity of illness and the appropriate reimbursement for the level of services rendered to patients.
• Facilitates modifications to clinical documentation through physician queries, extensive concurrent interaction with physicians, nursing staff and coding personnel.
• Actively provides education to physicians and staff on documentation guidelines.
• Responsible for medical record reviews and validation of codes such as ICD-10-CM/PCS, CPT, HCPCS, MS-DRG codes.
• Ability to research billing, coding and reimbursement regulations and summarize issues for discussions with client and counsel.
• Articulates complex coding and clinical terminology or ambiguous guidance for client and counsel.

Basic Qualifications

• Bachelor's Degree
• Registered Nurse (RN) with minimum of 3+ years of clinical experience
• 2+ years in Case Management/Utilization Review with proficiency using InterQual and MCG (Milliman Care Guidelines)
• +3+ years medical coding or clinical documentation improvement experience preferably in a consulting/professional services environment.
• Current coding certification: Certified Professional Coder (CPC) and/or Certifified Coding Specialist (CCS)
• Proficient use of grouper software and/or coding reference books to determine appropriate code assignment
• Proficient in use of computer, including MS-Outlook, Word and Excel (Windows PC Applications)
• Must be willing to travel weekly, some travel required (up to 50% annually).
• COVID Vaccine required*

Preferred Skills:

• Testifying, mediation or arbitration experience
• Demonstrated experience in the fundamentals of auditing and monitoring
• Ability to work both independently and as part of a team in a fast-paced, multi-task environment with a strong attention to detail.
• Ability to interface with team members and client personnel in demanding, deadline-driven situations.
• Excellent communication (both written and verbal) and organizational skills.
• Flexibility with respect to assigned tasks and engagements due to challenging deadlines, changing deliverables and evolving task priorities.
• Strong work ethic, eagerness to learn, and motivation to succeed.

*Individuals seeking an exemption from this requirement for medical or religious reasons should complete a request for accommodation form and submit the form to your recruiter.

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Our Benefits

Apart from the well-structured career path and excellent team environment, our employees enjoy a variety of perks and benefits. Our benefits include, but are not limited to:

• Competitive salary and bonus plans
• Generous paid holidays, time off and parental leave
• Full package of benefits plans
• Company matched 401K
• Annual paid volunteer hours
• Corporate matching for charitable donations
• Potential for flexible working arrangements
• Free snacks and drinks
• Upscale offices close to public transportation
• Pet insurance

About FTI Consulting

What makes us unique? With more than 6,250 employees located in offices in every corner of the globe, we are the firm our clients call when their most important issues are at stake. Regardless of what level you are, you will have the opportunity to work alongside and learn from top experts in your field on high-profile engagements that impact history. Our culture is collaborative, and we value diversity, recognition, development and making a difference in our communities.

FTI Consulting is publicly traded on the New York Stock Exchange and has been recognized as a Best Firm to Work For by Consulting magazine and one of America's Best Management Consulting Firms by Forbes . For more information, visit www.fticonsulting.com and connect with us on Twitter ( @FTIConsulting ), Facebook and LinkedIn .

FTI Consulting is an equal opportunity employer and does not discriminate on the basis of race, color, national origin, ancestry, citizenship status, protected veteran status, religion, physical or mental disability, marital status, sex, sexual orientation, gender identity or expression, age, or any other basis protected by law, ordinance, or regulation.