Protecting and Enhancing Revenue for Hospitals

Current Openings

Senior Consultant – Reimbursement – (Remote)

We are currently seeking an S-10 Sr. Consultant to work directly with the Director of Reimbursement Services to achieve the product line’s goals and objectives.

PRIMARY RESPONSIBILITIES:

  • Actively contribute to work projects in the areas of: Cost Reporting, DSH, S-10, and Wage Index.
  • Act in the role of Consultant for the product line activities, embodying the Core Values of the firm with equal responsibility and accountability to product line staff.
  • Must actively define need or problem, conduct research and analysis of data to recommend solutions for clients.  Conclusions should be objective, logical and based on facts that have been collected and verified.
  • Maintain accurate and current activity reporting. Enter hours and expenses where applicable by project as soon as possible. Enter clear and concise description of activities in time keeping system as appropriate.
  • Conduct client engagements, per the engagement methodology, and within the designated time period. Inform Director of Reimbursement Services of any potential delays that would impact the ability to complete assigned tasks within the allotted time.
  • Develop and maintain client relationships that continue to produce revenues for the firm over time.  Keep open lines of communication with active clients and keep clients abreast of new issues as they develop.
  • Assist in the development of specific recommendations and conclusions for the client. Conclusions should be objective, logical, and based on facts that have been collated and verified.
  • Maintain appropriate internal control safeguards over client records and collection of BESLER information.
  • Maintain compliance standards for providing accurate information on all product line work, proposals, and client activity.
  • Engage in industry group participation (HFMA, etc.).
  • Research and assist in the development of new product offerings.
  • Develop less experienced staff on issues and product offerings through ongoing instruction, coaching and counseling aimed at developing the type of skills and behaviors that will result in successful consulting engagements.

EXPERIENCE:

Demonstrated abilities and experience in the following areas:

  • Working knowledge in all areas of hospital/healthcare finance such as revenue cycle to include: Cost Reporting, DSH, S-10, and Wage Index.
  • Ability to identify, analyze and effectively address problems that impact operations or financial processes regardless of whether the problem originates in an area under direct or indirect control.
  • In-depth knowledge of hospitals, other healthcare providers and healthcare industry in general.
  • Knowledge of healthcare industry statistical indicators and the ability to analyze data related to operations.
  • Demonstrated leadership skills to motivate co-workers and cross-product line teams’ performance towards excellence and develop team concepts as well as consensus-building management styles along with the ability to make a significant contribution to product line’s overall effectiveness.
  • A minimum, of 15 years’ business experience in the healthcare (s/b specific to Reimbursement) field required along with strong organizational skills.
  • An ability to demonstrate Project Management experience. PMP certification is preferred.
  • Must be able to demonstrate specific detail knowledge about the Uncompensated Care regulations, data issues, and engagement activities.
  • Skills in using mainframe, MS Office Suite, and PC computers and related software essential to effective and efficient performance. (Cost Reporting Software is essential)
  • Knowledge of medical and general industry terminology. Working knowledge of Medicare and Medicaid Cost Reporting, Appeals, PRRB, MACs, Provider Audits.
  • Clear and effective communication skills.

 EDUCATION:

  • Bachelor’s degree required, preferably in business, finance, health or public administration, management, or a related field.
  • Master’s degree in business, finance, health or public administration is strongly preferred.

TRAVEL:

This position requires approximately 25% US travel for onsite meetings and client visits. Travel includes bi-annual all-employee meetings to NJ. Ability to work from home when not traveling to clients and/or company meetings/functions.

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.

Inpatient Coding Analyst – (Remote)

We are currently seeking an Inpatient Coding Analyst to work closely with the Strategic Solutions Director to achieve the Revenue Integrity Service Line’s goals and objectives.

PRIMARY RESPONSIBILITES:

  • Utilizing BESLER’s revenue integrity platform, review inpatient claims at all levels of complexity.
  • Query physicians when code assignments are not straightforward or documentation in the record is inadequate, ambiguous, or unclear for coding purposes.
  • Keep abreast of coding guidelines and reimbursement reporting requirements. Brings identified concerns to supervisor or department manager for resolution.
  • Abide by the Standards of Ethical Coding as set forth by the American Health Information Management Association and adheres to official coding guidelines.
  • Support and engage in education presentations (both face-to-face and remotely) associated with audit and review activities.
  • Maintain current knowledge of regulatory standards, which may impact utilization of processes and systems.
  • Seek 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.

EXPERIENCE:

Demonstrated abilities and experience in the following areas:

  • A minimum, 5+ years’ experience with inpatient coding/billing.
  • Demonstrated competency in use of computer applications including abstracting and encoding software.
  • DRG grouper software, MS office and hospital information systems.
  • 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.

EDUCATION:

  • Bachelors of Science degree in a related field, Associates in Health Information Technology minimally acceptable
  • RHIA or RHIT preferred, CCS credential required

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.

Outpatient Coding Analyst – (Remote)

We are currently seeking an Outpatient Coding Analyst to work closely with the Director Revenue Integrity Solutions to achieve the Revenue Integrity Service Line’s goals and objectives. This position has the ability to work remotely.

PRIMARY RESPONSIBILITES:

  • Utilizing BESLER’s revenue integrity platform, review outpatient claims at all levels of complexity
  • Review all charges, ensure accurate charge capture, and review medical necessity for all ordered tests/procedures. Ensure adequate documentation to support ordered services
  • Assign and sequence ICD-10-CM and CPT-4 codes (including modifiers) for all specialty patient types which may include observation, outpatient, ambulatory records, and emergency room records for billing and reimbursement
  • Assign and sequence evaluation and management services codes for all outpatient claim types
  • Review and analyze medical records for APC assignment to accurately reflect the diagnosis/procedures documented in the medical record. Participate in communication and education to client’s staff concerning documentation issues to support accurate coding and billing. Shares information in a professional and timely manner
  • Abstract clinical data, accurately after documentation assessment and review to ensure that it is adequate and appropriate to support the diagnoses and procedures selected to be abstracted
  • Maintain current knowledge of regulatory standards, which may impact utilization of processes and systems
  • Seek 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

EXPERIENCE:

Demonstrated abilities and experience in the following areas:

  • A minimum, 5+ years’ experience with outpatient coding/billing
  • Demonstrates competency in use of computer applications including abstracting and encoding software.
  • APC grouper software, MS office and hospital information systems
  • Understand 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 and CPT required,
  • Excellent oral and written communication skills, including the ability to interact with high-level of management.
  • Detailed-oriented and able to meet targeted deadlines

EDUCATION:

  • Bachelors of Science degree in a related field, Associates in Health Information Technology minimally acceptable
  • RHIA or RHIT preferred, CCS or CPC credential required

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.