Protecting and Enhancing Revenue for Hospitals

Current Openings

Full time- Coding Analyst, Inpatient – Remote

We are currently seeking an Inpatient Coding Analyst. This position can work remote.

Primary RESPONSIBILITLES:  

  • 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.

EDUCATION and EXPERIENCE:

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.
  • Bachelor 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.

Full time- Reimbursement Consultant NJ/NY/PA – Remote

We are currently seeking a Reimbursement Consultant – NJ/NY/PA with specific project work experience in NJ, PA, and NY. This position can work remote.

Primary RESPONSIBILITLES:  

  • Actively contribute to work projects in the areas of: Cost Reporting, DSH and Wage Index.
    • State specific work projects include: NJ DSH survey, NJ Shares Report, PA MA-336 Report, NY ICR Report, NJ DSH Processing including the “Judge Run” Report.
  • Must actively define need or problem, conduct research and analysis of data, in order to recommend solutions for clients.
  • Conduct client engagements, per the engagement methodology, and within the designated time period.
  • Exhibit the critical problem-solving skills needed to include:
    • The ability to break down a significant problem into its root causes and then design solutions to address each of the root causes.
    • Ability to analyze complex provider issues and identify the appropriate regulatory impact.
  • 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.
  • Ability to manage multiple projects simultaneously to ensure that deadlines are met and product quality are maintained.

EDUCATION and EXPERIENCE:

Bachelor’s degree required, preferably in business, finance, health or public administration, management, or a related field.

Demonstrated abilities and experience in the following areas:

  • Experience working with the following state specific criterion:
    • New Jersey DSH survey
    • New Jersey Shares Report
    • Pennsylvania MA-336 Report
    • New York ICR Report
    • New Jersey DSH Processing including the “Judge Run” Report
  • Individual is required to have excellent written skills as well as clear and effective communication skills.  The individual may be required to utilize these skills to facilitate or assist in presentations on behalf of the Reimbursement Team.
  • Working knowledge in the areas of hospital/healthcare settings such as cost reporting, IME/GME bad debt, wage index reviews, DSH and other areas as assigned to include health insurance practices, industry regulatory requirements and technology.
  • Demonstrated ability to problem-solving or detective style thinking in order to interface with staff, as well as with the client, in order to effectively detect areas with potential problems and ability to recommend solutions.
  • A minimum of 1-3 year’s healthcare or related business experience required along with strong organizational skills.
  • Skills in using mainframe and PC computers and related software essential to effective and efficient performance.
  • Knowledge of medical and general industry terminology.
  • Project Management Skills, ability to monitor and report on client engagement activities throughout the lifecycle of the engagement.

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.

Full time – Manager, Reimbursement – Remote

We are currently seeking a Reimbursement Manager. This position can work remote.

Primary RESPONSIBILITIES:

  • Must be able to demonstrate an understanding of the following Reimbursement activities and actively contribute to work projects in the areas of: Regulatory Research, Cost Reporting, DSH, Bad Debts, WS S-10, IME/GME, Organ Acquisition, Wage Index.
  • Actively manage the client engagement/project on a day to day basis working closely with Sr. Manager and Client to resolve issues
  • Develop superior client relationships that continue to produce revenues for the firm over time.
  • Execute and maintain strategic implementation plan for each engagement/client under management. Conduct review meetings at the end of an engagement to summarize findings, provide final documents and answer questions.
  • Assist in the development of public facing marketing materials
  • Assist in developing strategic partnerships where appropriate that add value to and/or facilitate the delivery of the consulting services offered.
  • Ensure clients are adequately serviced base on the scope of the project
  • Lead/Assist team in product line client work. Performs role of teammate, provides input and guidance to assigned staff during client engagement.
  • 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. Assists in the development of proposals working in conjunction with Sales and Legal to ensure that proposals include updated language and properly describes the scope of the project.  Work with Sr. Manager and Sales to follow-up on open proposals.
  • Assess and respond to organizational and customers’ needs with innovative programs to ensure customer satisfaction. Implement client friendly guidelines.
  • Manage client engagement and relationship in all aspects. Bring the engagement to completion on time and within the scope of the engagement terms and conditions.
  • Research and assist in the development of new product offerings.
  • Conduct public speaking engagements, article writing and educational webinars
  • Identify, analyze and effectively address and resolve data challenges that impact operations or financial processes with the client, regardless of whether the problem originates in an area under direct or indirect control
  • Exhibit the critical problem-solving skills needed to include:
    • The ability to break down a significant problem into its root causes and then design solutions to address each of the root causes.
    • Ability to analyze complex provider issues and identify the appropriate regulatory impact.
  • Learn state specific reporting requirements (Medicaid, DSH, Provider Tax, etc.)

EDUCATION & EXPERIENCE

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.

  • Working knowledge in all areas of hospital/healthcare finance such as revenue cycle to include: DSH, Wage Index and Cost Reporting.
  • 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 3 year’s business experience in the healthcare (s/b specific to Reimbursement) field required along with strong organizational skills.
  • A minimum, of 1-3 years management experience required.
  • Skills in using mainframe 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.

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.