Managing Consultant - Coding and Middle Revenue Cycle - Healthcare

About this role

We Do Consulting Differently

The Integrated Health Solutions (IHS) practice at Berkeley Research Group (BRG) provides end-to-end advisory support to healthcare providers, payers, investors, and other stakeholders navigating complex strategic, operational, financial, and clinical challenges. Led by seasoned healthcare executives, operators, and clinicians, IHS partners with organizations to drive sustainable performance improvement and long-term growth through strategic growth design, operating model transformation, AI and digital enablement, clinical quality and patient care optimization, and revenue strategy, helping clients build resilient, future-ready healthcare enterprises in an increasingly complex environment.
Our four core service offerings include:

• Business Transformation Advisory

• Margin & Operational Improvement

• Clinical & Quality Transformation

• AI & Digital Solutions

Margin & Operational Improvement drives measurable financial improvement by providing clients with comprehensive solutions designed to increase revenue, optimize costs, and achieve sustainable margin improvement. This division uses innovative approaches to transform operating models and deliver measurable, lasting results. Our team of operational leaders, business analysts, and experienced subject matter experts focuses on implementing solutions across the following areas:

• Workforce Productivity and Human Resources

• Supply Chain and Corporate Overhead Performance

• Revenue Cycle Effectiveness

• Managed Care, Revenue Integrity, and Pricing Strategies

• Ambulatory Operations and Physician Enterprise

Position Summary
We are currently seeking a Managing Consultant to join our Coding and Middle Revenue Cycle service line within our IHS practice. This position requires a highly motivated problem solver with strong analytical, organizational, project management, and client relationship skills. The ideal candidate will combine deep knowledge of healthcare coding and clinical documentation processes with demonstrated consulting, operational improvement, or transformation experience.
The Managing Consultant will lead and support qualitative and quantitative engagements focused on improving coding accuracy, compliance, productivity, timeliness, reimbursement, and financial performance. This individual will also support the continued expansion of BRG’s middle revenue cycle capabilities across coding, clinical documentation integrity, health information management, charge capture, revenue integrity, denials prevention, reimbursement, and related functions.
This position is not primarily a production coding or coding quality review role. The successful candidate must demonstrate experience applying coding and health information management expertise to consulting engagements, operational improvement initiatives, process redesign, financial analysis, technology enablement, or organizational transformation. The consultant must be extremely knowledge and current on coding regulations and be able to provide and support positions related to coding outcomes and decisions for across specialty practices.

Travel Requirements
Willing to travel consistently (50%–80%), depending on project requirements and client expectations, is required for this position.
Responsibilities

• Plan and manage small- to medium-sized coding and middle revenue cycle engagements and workstreams within larger, multidisciplinary projects.

• Lead assessments of coding, clinical documentation integrity, health information management, and related middle revenue cycle operations.

• Develop project charters, work plans, staffing and budget plans, schedules, risk registers, client deliverables, and benefit realization models.

• Manage project teams, delegate work, review analyses and deliverables, and monitor scope, staffing, budgets, timelines, and engagement performance.

• Identify operational, financial, compliance, workforce, and technology opportunities; develop prioritized recommendations and implementation roadmaps.

• Present findings, recommendations, project progress, risks, and financial results to client leaders.

• Assess inpatient, outpatient, professional fee, and ambulatory coding for accuracy, compliance, productivity, timeliness, reimbursement, and financial performance.

• Evaluate coding workflows, staffing models, organizational structures, productivity standards, quality programs, management reporting, and performance management practices.

• Assess health information management workflows, including chart completion, record integrity, coding queues, discharged-not-final-billed management, and physician query processes.

• Evaluate clinical documentation integrity processes and their integration with coding, utilization management, quality, revenue integrity, and denials prevention.

• Assess governance for coding and clinical documentation integrity, including accountabilities, escalations, performance standards, and committees.

• Analyze coding-related denials, clinical validation issues, claim edits, and payment variances; identify root causes and recommend preventive and corrective actions.

• Quantify the effects of coding backlogs, documentation deficiencies, incomplete records, late charges, and other middle revenue cycle breakdowns.

• Evaluate coding audit and quality assurance programs, including sampling, accuracy standards, education, corrective actions, and monitoring.

• Assess internal, outsourced, and hybrid coding models, including vendor performance, service levels, quality controls, capacity, productivity, and cost.

• Review and improve coding, clinical documentation integrity, and health information management policies and procedures in line with applicable requirements.

• Design and support implementation of future-state operating models, governance, workflows, policies, controls, performance standards, and monitoring tools.

• Analyze coding, documentation, billing, claims, denials, workforce,…