Navigant Senior Consultant - Coding, Provider Compliance - Remote Location in PLANKINTON, South Dakota

Navigant Consulting, Inc. (NYSE: NCI) is a specialized, global professional services firm that helps clients take control of their future. Navigant’s professionals apply deep industry knowledge, substantive technical expertise, and an enterprising approach to help clients build, manage and/or protect their business interests. With a focus on markets and clients facing transformational change and significant regulatory or legal pressures, the Firm primarily serves clients in the healthcare, energy and financial services industries. Across a range of advisory, consulting, outsourcing, and technology/analytics services, Navigant’s practitioners bring sharp insight that pinpoints opportunities and delivers powerful results. More information about Navigant can be found at navigant.com.

Navigant’s Life Sciences Disputes, Regulatory, Compliance and Investigations practice focuses on assisting corporations and their counsel in addressing the issues associated with complex disputes, investigations, regulatory and compliance, and technology services. Our disputes professionals provide expert testimony and privileged consulting on damage quantum, liability and valuation issues on complex commercial disputes. Our regulatory specialists deliver both proactive and reactive regulatory advisory services, ranging from product submissions to the FDA, to post 483 remediation. Our compliance professionals support clients through the development, implementation and evaluation of healthcare compliance programs. They also act as monitors in Independent Review Organization roles, support the implementation of Corporate Integrity Agreements and support Compliance Officers and Boards in an advisory capacity.

Our investigations professionals provide privileged and independent consulting on complex issues related to the False Claims Act, Anti-kickback Statute, the Physicians Payments Sunshine Act and the Food, Drug and Cosmetics Act, which may result in expert testimony and reporting to management, boards and regulators on accounting disputes, auditor malpractice and individual white collar defense. In global investigations, we combine deep investigative law enforcement, industry and accounting skills on anti-money laundering, bribery & corruption, public sector & monitoring, healthcare and government contracting compliance & investigative matters, including discovery services, compliance technology and complex data management.

We deliver technology services to assist in the litigation and investigation process and in solving business problems practice areas and have technology platforms established related to compliance needs, such as compliance program effectiveness and reporting, Open Payment reporting and Arrangements Databases supporting interactions between the industry and Healthcare Professionals.

  • Proficiency in medical coding, billing, and documentation requirements, including a working knowledge of national and state-specific guidelines for Medicare and Medicaid

  • Understands current Healthcare Compliance trends, concepts and issues

  • Responsible for writing clear, concise and client-ready reports on their medical record findings and client compliance process reviews

  • Builds relationships and manages client relationships while growing the NCI portfolio

  • Demonstrates strong communication skills both written and oral

  • Exhibits strong leadership skills

  • Recognizes and manages risks for the firm and client

  • Utilizes creative problem solving techniques

  • Provides strategic analysis

  • Working collaboratively within a team setting

  • Minimum 5 years’ experience in clinical care (acute inpatient hospital experience preferred)

  • Coding certification (will consider non-coders with an aptitude to achieve certification within a defined period of time)

  • Analytical skills related to independently interpreting medical record documentation for medical necessity or other guidelines

  • Knowledge of Inter Qual or Milliman care guidelines

  • Self-directed, independent individual with the ability to review clinical records in electronic or paper format with minimal direct supervision

  • Proficient in Excel, Word, and PowerPoint skills and ability to independently produce documents

  • Flexible, positive, with clear interpersonal and communication skills

  • Ability to facilitate the exchange of information within all levels of NCI as well as a provider based client organization, including, but not limited to, surgeons, anesthesiologists, hospital executives, and other professional and ancillary staff

  • Ability to ensure and promote consistent, quality oriented, best practices in all disputes and investigations projects

  • Management experience including facilitation and supervision preferred

  • Capacity to adapt and lead others to understand and accept values, strategies, goals and plans in response to changing business conditions

  • Frequently communicates with clients and coworkers and must be able to share information effectively

  • Strong conceptual, as well as quantitative and qualitative analytical skills

  • Work as a member of a team as well as be a self-motivator with ability to work independently

  • Flexibility and responsiveness in managing multiple projects in sometimes high-pressure situations simultaneously

  • Able to travel via airplane with minimal assistance to client sites across the US and potentially internationally

  • Usually remains stationary for the majority of the day

  • Regularly uses close visual acuity and operates computer equipment to prepare and analyze and transmit data

The company offers competitive compensation packages including an incentive compensation plan, comprehensive medical/dental/life insurance, 401(k) and employee stock purchase plans.

Navigant does not accept unsolicited resumes through or from search firms or staffing agencies. All unsolicited resumes will be considered the property of Navigant and Navigant will not be obligated to pay a placement fee.

Navigant is an Equal Opportunity / Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, citizenship status, protected veteran status, religion, creed, physical or mental disability, medical condition, marital status, sex, sexual orientation, gender identity or expression, age, or any other basis protected by law, ordinance, or regulation.