Director, Registered Nurse /Certified Coder

Ankura is a team of excellence founded on innovation and growth.

Practice Overview:

Ankura’s Health Care team is a recognized leader in health care disputes, compliance, and investigations. We combine unparalleled clinical, technical, and operational expertise with financial, economic, analytic skills. Our clients and their legal counsel rely upon us to successfully resolve complex matters. Ankura’s health care team is comprised of clinicians, certified coders, revenue cycle, and operations professionals. Our practice leaders each have over 25 years of health care and consulting experience. The Ankura team has a mastery of the data and information systems used by providers, payers, and CMS. We combine in-depth operational, compliance, and clinical industry knowledge with exceptional data analytics, information-gathering, and forensic skills enabling us to help our clients and their legal counsel assess and quantify the potential impact of a dispute. Our clients include the largest and most prominent US health care providers, payers, and law firms.

Role Overview:

Our directors use their industry knowledge related to billing, coding, and clinical operations, along with their project management capabilities, to develop custom solutions for clients facing high-profile and complex investigations and commercial disputes. The context for the projects we perform includes government investigations, whistleblower lawsuits, internal investigations, payer/provider disputes, and acquisition due diligence, among others.

Responsibilities:

• Proficient in medical coding, billing, and documentation requirements

• Works with Project Managers to analyze and understand client concerns and develop project work plans as requested

• Understands health care compliance concepts, issues, and how to research and access regulatory guidelines and reference materials

• Conducts independent review of medical records – EMR (electronic medical records) or paper documentation

• Drafts clear and concise analyses of medical record review and coding findings 

• Ensures successful completion of high-quality project deliverables as assigned and within the desired timeframe

• Works collaboratively with Ankura team members focusing on building and maintaining internal and external client and counsel relationships

• Able to multi-task, prioritize client work, and assist with Project Management

• Identifies opportunities for cross practice collaboration

• Proven writing and presentation skills and has a keen sense of attention to detail

• Communicates findings of concern with the team and Project Manager as they are identified

• Utilizes creative and critical thinking problem-solving techniques

Qualifications:

• Bachelor’s degree in nursing from an accredited college/university

• Certified in health care coding– inpatient, outpatient, and professional services

• Experience in clinical setting utilizing nursing education and training

• Familiar with revenue cycle processes and facility and professional claims

• Demonstrates excellent communication skills, both written and oral

• Experience managing small projects and teams

• Familiar with accessing and identifying clinical documentation in electronic medical record systems

• Proficient in Excel, Word, and PowerPoint and able to draft reports and presentations and present findings

• Ability to problem solve, multi-task, and prioritize assignments

• Understands the importance of privileged and confidential communication

• Willingness to travel when needed

• Must be legally authorized to work in the United States without the need for employer sponsorship, now or at any time in the future.

For individuals assigned and/or hired to work in California, Colorado, or New York, Ankura is required to include a reasonable estimate of the compensation range for this role. This compensation range is specific to the said markets and considers a broad range of factors including but not limited to skill sets, experience and training, licensure and certifications, and other business and organizational needs. The disclosed range estimate has not been adjusted for the applicable geographic differential associated with the location at which the position may be filled.  The range does not include additional benefits outside of salary. A