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Associate, Healthcare Forensics - Disputes, Claims, & Investigations

Associate, Healthcare Forensics - Disputes, Claims, & Investigations

StoutCleveland, OH, United States
4 days ago
Job type
  • Full-time
Job description

At Stout, we're dedicated to exceeding expectations in all we do - we call it Relentless Excellence . Both our client service and culture are second to none, stemming from our firmwide embrace of our core values : Positive and Team-Oriented, Accountable, Committed, Relationship-Focused, Super-Responsive, and being Great communicators. Sound like a place you can grow and succeed? Read on to learn more about an exciting opportunity to join our team.

About Stout's Forensics and Compliance Group

Stout's Forensics and Compliance group is dedicated to helping organizations navigate complex challenges surrounding compliance, investigations, and regulatory matters. Our team of professionals combines deep technical expertise with industry insights to identify fraud, waste, abuse, and operational inefficiencies while fostering a culture of integrity and accountability. We partner with clients to implement proactive measures, support litigation efforts, and optimize systems and processes for sustainable success.

What You'll Do

Here, you'll find the core responsibilities and day-to-day duties of the role. These tasks are designed to help you achieve the desired outcomes while supporting team and organizational goals.

Participate in client engagements focused on healthcare billing, coding, reimbursement, and revenue cycle operations.

Contribute to the forensic investigations and compliance reviews to identify potential fraud, waste, abuse, and operational inefficiencies.

Assist with understanding EMR / EHR Hospital Billing (e.g., EPIC Resolute) workflows and configurations, ensuring accurate charge capture and efficient revenue cycle processes.

Support Stout teams and client compliance teams, legal counsel, and leadership to support audits, litigation, and corrective action plan development.

Communicate regularly with engagement managers, directors, team members, and other stakeholders to ensure successful project delivery.

Support EMR / EHR system implementations and enhancements, including testing, migration, and post-go-live stabilization.

Develop and deliver detailed reports, analyses, and presentations summarizing investigative findings and improvement recommendations.

Foster individual skill growth and develop strong client delivery.

Stay informed on emerging healthcare regulatory changes, EMR / EHR updates, payer policies, and industry trends.

Contribute to practice thought pieces and other industry initiatives within Stout's Healthcare Consulting team.

What You Bring

This section details the skills, qualifications, and work history needed to excel in the role. It provides a snapshot of the expertise and experience we're looking for in the ideal candidate.

Bachelor's degree in Healthcare Administration, Information Technology, Computer Science, Accounting, or a related discipline required; Master's preferred.

Three (3)+ years of healthcare revenue cycle operations, EMR / EHR implementation, and / or compliance-based experience required.

One (1)+ years delivering consulting projects or investigations in billing, coding, or reimbursement required.

Current Epic Certification in Resolute or other Hospital Billing certifications preferred.

Nationally recognized coding credential (e.g., CCS, CPC, RHIA, RHIT) required.

Additional certifications such as CHC, CFE, or AHFI preferred.

Demonstrated experience with EMR / EHR system design, build, troubleshooting, and optimization.

Proficiency in Microsoft Office Suite, Visio, and SharePoint required; experience with analytics or visualization tools (e.g., Tableau or PowerBI) preferred.

Strong understanding of applicable regulatory frameworks (CMS, HIPAA, False Claims Act) and payer compliance guidelines.

Ability to travel up to 25%, depending on client and project needs.

How You'll Thrive

This section focuses on the competencies and behaviors that will set you up for success in this role. It highlights the personal attributes, mindset, and ways of working that align with our culture and values.

Analytical and Insightful : You think critically, dig deep into data, and surface meaningful insights that drive compliance and financial integrity.

Collaborative and Client-Focused : You build trust through transparency, clear communication, and consistent delivery of high-quality work.

Driven and Accountable : You take ownership of your projects, meet deadlines, and hold yourself and your teams to the highest standards.

Adaptable and Curious : You embrace new challenges, technologies, and regulatory changes with curiosity and agility.

Mentor and Team Builder : You enjoy developing others, fostering a learning culture, and helping colleagues grow their expertise.

Aligned with Stout Values : You demonstrate integrity, inclusivity, and excellence in everything you do-helping clients and teammates succeed.

Why Stout?

At Stout, we offer a comprehensive Total Rewards program with competitive compensation, benefits, and wellness options tailored to support employees at every stage of life.

We foster a culture of inclusion and respect, embracing diverse perspectives and experiences to drive innovation and success. Our leadership is committed to inclusion and belonging across the organization and in the communities we serve.

We invest in professional growth through ongoing training, mentorship, employee resource groups, and clear performance feedback, ensuring our employees are supported in achieving their career goals.

Stout provides flexible work schedules and a discretionary time off policy to promote work-life balance and help employees lead fulfilling lives.

Learn more about our benefits and commitment to your success.

https : / / www.stout.com / en / careers / benefits

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

Stout is an Equal Employment Opportunity. All qualified applicants will receive consideration for employment on the basis of 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 but not limited to 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 not typical for an individual to be hired at or near the top of the range for their role and compensation decisions are dependent on the facts and circumstances of each case.

A reasonable estimate of the current range is $74,000.00 - $135,000.00 Annual. This role is also anticipated to be eligible to participate in an annual bonus plan. Information about benefits can be found here - https : / / www.stout.com / en / careers / benefits.

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Healthcare Associate • Cleveland, OH, United States

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