The Coding Analyst will work closely with the Director of Revenue Integrity to achieve the Revenue Integrity Service Line’s goals and objectives and Company-wide goals and initiatives. The Coding Analyst will be responsible for supporting the BESLER Revenue Integrity Service Line by providing inpatient coding reviews. The Coding Analyst will utilize BESLER’s proprietary revenue integrity platform and their unique experience to identify revenue integrity related issues for our customers.
- Utilizing BESLER’s revenue integrity platform, review claims at all levels of complexity for inpatient claims:
- Review whether the complexity of the visit meets the medical necessity criteria for the code level assigned.
- Review whether all documented CPT procedures are captured and coded correctly.
- Review whether the diagnoses (represented by the ICD-10-CM coding) are accurate.
- Review whether DRG’s are assigned correctly, and if all Diagnoses and procedure codes are identified.
- Review claims for Specialty Code focused Audits
- Support and engage in education presentations (both face-to-face and remotely) associated with audit and review activities.
- Maintains current knowledge of regulatory standards, which may impact utilization of processes and systems.
- Seeks opportunities for individual growth and development, including attending various meetings, conferences, and courses, as required,
- Responsible for meeting departmental productivity and quality expectations.
- Consult with client organizations and their department heads at the direction of the service line director.
- Collaborate with other service line team members to meet client demands and to develop strategies for service line growth and operational improvement.
- Communicate consistently with all project team members and general BESLER colleagues regarding the status and results of service line business operations.
- Contribute to publications, presentations and white papers on behalf of organization as requested.
- Carry out all other ad hoc requests as determined by business needs.
- Travel to client sites as may be required.
- This position performs other duties as assigned.
Demonstrated abilities and experience in the following areas:
- A minimum, 5+ years’ experience with inpatient coding/billing.
- Demonstrates competency in use of computer applications including abstracting and encoding software.
- APC and DRG grouper software, MS office and hospital information systems.
- Understands Outpatient Code Editor edits.
- Demonstrated knowledge in hospital/healthcare settings such as revenue cycle, clinical experience, charge description master, coding, reimbursement, health insurance practices, industry regulatory requirements, business office operations, technology, and industry standards for healthcare resolution management practices.
- Knowledge of ICD-10 required, ICD-10 Trainer experience highly desired.
- Excellent oral and written communication skills, including the ability to interact with high-level of management.
- Detailed-oriented and able to meet targeted deadlines.
- Bachelors of Science degree in a related field, Associates in Health Information Technology minimally acceptable
- RHIA or RHIT preferred, CCS credential required
- Ability to define problems, collect data, establish facts and draw valid conclusions.
- Ability to synthesize regulatory requirements and apply to business projects/activities on a regular basis.
- Good interpersonal and presentation skills.
- Ability to comprehend and apply applicable healthcare regulations.
- Ability to multitask, be flexible, remain composed under pressure, support teammates, and think critically.
- Project management skills.
Interested applicants should submit their credentials to email@example.com for consideration.
Besler Consulting is an equal opportunity employer committed to inclusion and compliant with all applicable laws.