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Healthcare Medical Coding Analyst - Claims and Investigations
Healthcare Medical Coding Analyst - Claims and InvestigationsStout • Los Angeles, CA, United States
Healthcare Medical Coding Analyst - Claims and Investigations

Healthcare Medical Coding Analyst - Claims and Investigations

Stout • Los Angeles, CA, United States
Hace 3 días
Tipo de contrato
  • A tiempo completo
Descripción del trabajo

Join Stout and embrace our commitment to Relentless Excellence! We pride ourselves on outstanding client service and a culture that fosters growth and collaboration. If you're ready to thrive in a positive, team-oriented environment, this is a rewarding opportunity for you.

About Stout's Forensics and Compliance Group :

Our Forensics and Compliance group is crucial in helping organizations navigate compliance, investigative, and regulatory challenges. Our experts leverage technical skills and healthcare experience to uncover fraud, waste, abuse, and operational inefficiencies, fostering a culture of integrity and accountability.

In this Analyst role, you will :

  • Work directly with clients to support healthcare billing, coding, reimbursement, and revenue cycle operations.
  • Conduct thorough forensic analyses and compliance reviews to uncover potential fraud, waste, abuse, and process inefficiencies.
  • Examine and document EMR / EHR hospital billing workflows (e.g., Epic Resolute) to focus on charge capture, claims processing, and reimbursement logic.
  • Assist in audits, investigations, and litigation support, from gathering evidence to identifying issues and planning corrective actions.
  • Collaborate with Stout teams, client compliance functions, legal counsel, and leadership to ensure project objectives are met.
  • Facilitate EMR / EHR implementations and optimization initiatives, including testing systems, validating data, reviewing workflows, and providing post-go-live support.
  • Create clear, structured analyses, reports, and engaging presentations summarizing key findings, risks, and recommendations.
  • Maintain proactive communication with managers and project teams to ensure quality outcomes and timely delivery.
  • Enhance your technical, analytical, and consulting skills while establishing credibility with clients.
  • Stay informed on healthcare regulations, payer rules, EMR / EHR advancements, and industry trends affecting compliance and reimbursement.
  • Contribute to knowledge sharing and practice development within Stout's Healthcare Consulting team.

What You Bring :

  • A bachelor's degree in Healthcare Administration, IT, Computer Science, Accounting, or a related field; a master's degree is preferred.
  • At least two years of experience in healthcare revenue cycle operations, EMR / EHR implementations, compliance, or healthcare consulting.
  • Experience supporting consulting engagements, audits, or investigations in billing, coding, reimbursement, or compliance.
  • Familiarity with Epic Resolute or similar hospital billing systems; Epic certification is a plus.
  • A recognized coding credential (e.g., CCS, CPC, RHIA, RHIT) is required.
  • Additional certifications like CHC, CFE, or AHFI are preferred.
  • Working knowledge of EMR / EHR system configuration, workflows, issue resolution, and optimization.
  • Proficiency in Microsoft Office (Excel, PowerPoint, Word); experience with Visio, SharePoint, Tableau, or Power BI is a plus.
  • Solid understanding of healthcare regulatory and compliance frameworks, including CMS regulations, HIPAA, and the False Claims Act.
  • A willingness to travel up to 25% based on client and project needs.
  • How You'll Thrive :

  • Analytical and Detail-Oriented : Comfortable working with complex data and systems, skilled at identifying risks and forming well-supported conclusions.
  • Collaborative and Client-Focused : Clear communicator who excels in team environments and fosters client relationships.
  • Accountable and Proactive : Takes ownership of work, effectively prioritizes tasks, and consistently delivers high-quality results on time.
  • Adaptable and Curious : Eager to learn about new systems, regulations, and methodologies in a fast-paced consulting environment.
  • Growth-Oriented : Actively seeks feedback and opportunities to develop technical and professional skills aiming for increased responsibility.
  • Aligned with Stout Values : Demonstrates integrity, professionalism, and a commitment to excellence in all interactions.
  • Why Stout?

    At Stout, we offer a comprehensive Total Rewards program that includes competitive compensation, benefits, and wellness options tailored for every stage of life. We cultivate a culture of inclusion and respect, valuing diverse perspectives to drive innovation and success. Our leadership is dedicated to fostering inclusion and belonging across our teams and the communities we serve. Professional growth opportunities include training, mentorship, employee resource groups, and clear performance feedback, ensuring our employees achieve their career goals. Stout promotes work-life balance with flexible schedules and a discretionary time-off policy.

    The specific statements shown in each section are not intended to be all-inclusive. They represent typical elements and criteria necessary to perform the job successfully.

    Stout is an Equal Employment Opportunity.

    All qualified applicants will receive consideration for employment based on valid job requirements, qualifications, and merit without regard to race, color, religion, sex, national origin, disability, age, protected veteran status, or any other characteristic protected by applicable local, state, or federal law.

    Stout is required by applicable state and local laws to include a reasonable estimate of the compensation range for this role. The range for this role considers several factors, including prior work and industry experience, education level, and unique skills. The disclosed range estimate has not been adjusted for any applicable geographic differential associated with the location at which the position may be filled. It is uncommon for an individual to be hired at or near the top of the range for their role; compensation decisions depend on the facts and circumstances of each case.

    A reasonable estimate of the current range is $60,000.00 - $130,000.00 Annual. This role is also anticipated to be eligible for an annual bonus plan. Information about benefits can be found in our internal resources.

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