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 is an equal opportunity employer committed to inclusion and compliant with all applicable laws.
BESLER is seeking a Senior Software Architect, under the guidance of the Director of Software Development, to design, install and administer BESLER business applications and services.
Strategy and Planning
- Plan, design, modify, develop and implement software programming applications (as identified through various needs of BESLER product lines and key areas of business).
- Develop software requirements and specifications, including backup and maintenance plans.
- Design and develop software for specific internal and client applications.
- Schedule and organize development, testing, deployment and documentation plans.
- Evaluate and recommend third party development utilities and components.
- Write status reports and coordinate project resources in conjunction with schedules and assigned activities with the Director of Software Development.
- Write code and complete programming; testing of systems and applications based on approved project
- Write build scripts and automate test environments; manage multiple environments for internal acceptance testing.
- In coordination with BESLER leadership, Interfaces with customers to identify needs and evaluate alternative business solutions.
- Convert project specifications and procedures to detailed logical flow charts (as required for various project assignments).
- Estimate growth and plan hardware resources needed for deployment and product growth.
- In conjunction with the Director of Software Development, align the IT vision with the overall business strategy of BESLER and deliver functional automated tools to the various business units within the organization (such as the Product Line Divisions, Finance, Sales and other key areas of operations).
- Engage and plan with all service lines to share product data or resources that are not product-specific.
Required Education and Experience:
- Degree or other post-secondary education preferred or equivalent work experience.
- Job knowledge: Work in areas of computer hardware and software
- Development, to include operating systems and applications systems at a senior leadership, or executive
- Minimum of five years of software development and architecture experience
Required Knowledge, Skills, and Personal Qualifications:
As a key element of this position, the employee must possess leadership and management skills, as well as, the ability to know when to utilize them. The employee must also be able to work effectively with a wide variety of staff, stakeholders, clients and outside agencies as a team player.
Experience with the following technologies, tools and concepts are required:
- Web and Windows development utilizing Microsoft.Net
- C# language
- Continuous Integration
- Microsoft SQL Server
- Version control systems
- One or more Agile development methodologies
- Design Patterns
Experience with the following technologies, tools and concepts are helpful:
- IIS configuration
- NoSQL Database Technologies
- NHibernate/Fluent NHibernate
- Healthcare Data
- X12 EDI (835/837i/270/271/999)
- Team City
- MVC (preferably Microsoft MVC)
- NET Identity
- Web Services & Service-Oriented Architecture, including encryption
- PDF/Excel reading/writing via code
Leadership (Personal Qualifications)
- Proactive Leader – Works well without close supervision.
- Works well as a member of a team.
- Strong communication abilities, able to collaborate and be a team player.
- Values community brings a spirit of enthusiasm and energy.
- Demonstrates core values of respect for the individual, integrity, excellence, and commitment to learning.
- Possesses good communication skills (writing, spelling, listening, and speaking).
- Demonstrates knowledge and good judgment in matters of IT industry policy and procedures.
- Able to help staff develop and understand strategic plans.
- Excellent interpersonal skills in the areas of creative problem-solving, conflict resolution, group planning, and decision-making processes.
Interested applicants should submit their credentials to employment@BESLER.com for consideration.
BESLER is an equal opportunity employer committed to full compliance with all applicable laws.