Analyst, Healthcare Coding - Disputes, Claims & Investigations

About Stout’s Forensics and Compliance Group

Stout’s Forensics and Compliance group supports organizations in addressing complex compliance, investigative, and regulatory challenges. Our professionals bring strong technical capabilities and healthcare industry experience to identify fraud, waste, abuse, and operational inefficiencies, while promoting a culture of integrity and accountability. We work closely with clients, legal counsel, and internal stakeholders to support investigations, regulatory inquiries, litigation, and the implementation of sustainable compliance and revenue cycle improvements.

What You’ll Do

As an Analyst, you will play a hands-on role in client engagements, contributing independently while collaborating closely with senior team members. Responsibilities include :

Support and execute client engagements related to healthcare billing, coding, reimbursement, and revenue cycle operations.

Perform detailed forensic analyses and compliance reviews to identify potential fraud, waste, abuse, and process inefficiencies.

Analyze and document EMR / EHR hospital billing workflows (e.g., Epic Resolute), including charge capture, claims processing, and reimbursement logic.

Assist in audits, investigations, and litigation support engagements, including evidence gathering, issue identification, and corrective action planning.

Collaborate with Stout engagement teams, client compliance functions, legal counsel, and leadership to support project objectives.

Support EMR / EHR implementations and optimization initiatives, including system testing, data validation, workflow review, and post–go-live support.

Prepare clear, well-structured analyses, reports, and client-ready presentations summarizing findings, risks, and recommendations.

Communicate proactively with managers and project teams to ensure alignment, quality, and timely delivery.

Continue developing technical, analytical, and consulting skills while building credibility with clients.

Stay current on healthcare regulations, payer rules, EMR / EHR enhancements, and industry trends impacting compliance and reimbursement.

Contribute to internal knowledge sharing, thought leadership, and practice development initiatives within Stout’s Healthcare Consulting team.

What You Bring

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

Two (2)+ years of experience in healthcare revenue cycle operations, EMR / EHR implementations, compliance, or related healthcare consulting roles.

Experience supporting consulting engagements, audits, or investigations related to billing, coding, reimbursement, or compliance.

Epic Resolute or other hospital billing system experience preferred; Epic certification a plus.

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

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

Understanding of key healthcare regulatory and compliance frameworks, including CMS regulations, HIPAA, and the False Claims Act.

Willingness to travel up to 25%, based on client and project needs.

How You’ll Thrive

Analytical and Detail-Oriented : You are comfortable working with complex data and systems, identifying risks, and drawing well-supported conclusions.

Collaborative and Client-Focused : You communicate clearly, work well in team-based environments, and contribute to positive client relationships.

Accountable and Proactive : You take ownership of your work, manage priorities effectively, and deliver high-quality results on time.

Adaptable and Curious : You are eager to learn new systems, regulations, and methodologies in a fast-paced consulting environment.

Growth-Oriented : You seek feedback, develop your technical and professional skills, and build toward increased responsibility.

Aligned with Stout Values : You demonstrate integrity, professionalism, and a commitment to excellence in all client and team interactions.

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.

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.