: Senior Business Consultant
30 Corporate Drive
Burlington, MA 01803

Employee Testimonials

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Burgess Description

 

Why us? 

You’ll have a positive impact on the world.

Each year in America, healthcare businesses waste millions of hours and billions of dollars trying to get payments right. Our flexible software and accurate data feeds help clients eliminate this administrative waste, work more closely with their partners, and ultimately, provide more certainty for people at the point of care.

Position Summary:

The Business Consultant leads and mentors the Service Delivery team in all Tier 1 (Basic) and Tier 2 (Intermediate) consulting initiatives. The position provides in-depth and comprehensive subject matter expertise related to Burgess products (from basic to advanced features/functionality), payment methodologies/policies (Medicare, Medicaid, and commercial), payment integrity, and healthcare plan operations (e.g., claim life cycle/workflow, network contracting, payment/policy configuration, provider relations, medical management, medical economics, audit, compliance) related to implementation/consulting engagements, strategic user adoption initiatives, and ongoing client support.

What you will do:

Education and Consulting (implementation/consulting engagements, strategic user adoption initiatives, and on-going client support)

  • Provide the highest level of product education (from basic to advanced features/functionality to Burgess end-users
  • Provide in-depth and comprehensive subject matter expertise related to:
    • Medicare, Medicaid, and commercial payment methodologies/policies
    • Payment integrity
    • Healthcare plan operations (e.g., claim adjudication life cycle/workflows, network contracting, payment/policy related configuration, provider relations, medical management, medical economics, audit, compliance)
  • Conduct collaborative scoping sessions to identify client needs and appropriate solutions
  • Actively manage and/or participate in the development, maintenance, and execution of client facing education services 

 

Enhancement/Issue Escalation

  • Manage issues, questions, inquiries of Tier 1 and 2 escalation
  • Serve as escalation point for critical client needs as warranted.
  • Lead diagnosis and resolution of escalated and more involved/complex client problems and issues.
  • Act as a liaison between clients and internal support staff (research, development, and product teams) to assure accurate problem interpretation and resolution.
  • Capture and solicit issues/feedback from clients and internal stakeholders and document issues and client impacts.
  • Partner with appropriate Burgess Teams (BA, PM, Development, Account Management, Sales/Business Development, Product, Content, and Service Delivery) to manage problem framing, diagnosis and resolution.
  • Conduct/participate in root cause analysis to identify and deliver warranted service improvements.
  • Maintain demeanor as a calming influence during pressure situations, mixing in the correct degree of professional assertiveness without becoming aggressive.
  • Maintain communication with customers during the problem resolution process, utilizing superior customer service skills.

 

Capability/Tool Development/Maintenance

  • Leverage capabilities and tools (knowledge libraries, workflow, issue identification and documentation, function processes).
  • Lead capability and tool development under direction of Service Delivery Leadership.

 

Staff/Team Management/Supervision

  • Mentor and provide oversight for Tier 1 and 2 Service Delivery staff
  • Take direction from and collaborate with Service Delivery Leadership to continually review and enhance performance and strategy.

 

What You Bring:

  • Bachelor’s degree in a business, health services administration, mathematics, science or related field, and/or equivalent work experience required.
  • AHIP, HFMA, AAPC, and/or AHIMA certification preferred.
  • 5+ years training, education, and/or consulting experience preferred.
  • Practical understanding of the healthcare system with regards to Medicare, Medicaid, managed care, and commercial payment methodologies, payment integrity, and health plan operations (e.g., claim life cycle/workflows, network contracting, payment/policy related configuration, provider relations, medical management, medical economics, audit, compliance).
  • Experience with interpretation/translation of complex health-plan in-network and out-of-network provider rate and/or claim editing provisions.
  • Experience with configuration and maintenance of provider rate and/or claim editing provisions in a claims adjudication system and/or third-party vendor application.
  • Working knowledge of claim billing specifications (e.g., CMS-1500, UB-04, 837, HIPAA code sets).
  • Creative problem-solving skills including the ability to identify, recommend, and implement strategic solutions.
  • Ability to manage issues, requests, problems, and situations of all Tier 1 and 2 escalation levels.
  • Demonstrated ability to conduct education/training sessions to large audiences across multiple skill levels.
  • Strong analytical skills.
  • Excellent organizational skills.
  • Excellent communication (both written and verbal) and interpersonal skills.
  • Ability to learn and adapt to new technologies and systems.
  • Ability to adapt to a changing and rapidly growing environment.
  • Effectively manage multiple priorities and follow through on all projects to completion.

 

Who You Are:

  • Creative entrepreneur. You have a constant drive to make things better; you question the status quo and approach common challenges with creativity and constructive criticism. You have skills to clearly and convincingly share ideas in a way that adapts to your audience, regardless of function, level, or expertise.
  • Critical, big-picture thinker. You have a constant thirst for knowledge and the ability to credibly share it with others, whether internally or externally. You are analytical, evaluating logic-based details while always considering and problem solving for the sake of the big picture.
  • Self-starter. You are proactive, self-motivated, and able to push work, start initiatives, and provide ideas independently in a team environment.
  • Team player & coach. You can foster professional and personal respect from others and find success in a team setting. While highly collaborative, you have natural management skills and know how to grow and develop people.
  • Adaptable multi-tasker. You are highly organized and flexible. You know how to manage expectations and are able to thrive in fast-paced, constantly changing environments and successfully adapt to a variety of tasks.

 

How We Work:

  • Collaborative. We work together and help each other do our best by building on our work across teams and offices. We don’t own individual ideas or seek credit.
  • User-driven. We place our clients and our users’ needs above all else. If it matters to a user, it matters to us. We work for them and keep ourselves accountable to that.
  • Hands-on. We don’t wait for problems to solve themselves. We enter the thick of it and get things done.
  • Impact over ego. Our culture is about results, not ownership. Great ideas have seniority over titles and levels, and great thinkers outshine fancy pedigrees.
  • Forward-looking. We look beyond our own world to constantly improve our business. We welcome outside speakers, tap into the latest tech, and make sure we’re future proof in anticipation of what’s coming next.
  • Caring & close knit. We know and care about our people. We know each other’s project strengths—but also about upcoming family trips and favorite after work drinks

 

Full-time

Employee Testimonials

Lynne Hollinsworth
Manager, Configuration Center of Excellence

"Having spent many years leading Operations departments for various health plans, I joined HealthEdge because of the opportunity to use my background and expertise in an independent contributor role. I was impressed by the Company’s modern and practical approach to administering a core administration system. I am extremely glad to have shifted my career focus, and the employee focused culture, forward thinking, and spirit of teamwork are the qualities I enjoy most about working at HealthEdge."- Lynne, Manager, Configuration Center of Excellence

 
Adam Kacenjar
Program Director, Clinical Solutions

"I joined HealthEdge in the early startup days and thrived on the creative chaos and opportunities. While the company has grown significantly over the past 15 years, I appreciate the changing pace - issues of scaling, performance, mastering quality - these are the challenges where we are focused."- Adam Kacenjar

Dannette Coleman
EVP, Business Development

"HealthEdge is not just a software company, we are a solutions company, partnering with our customers to drive forward their business strategies using our products and services." - Dannette, EVP, Business Development

Kelly Donovan
Controller

"I am lucky to be on a team that consistently works together, has each other’s backs and enjoys each other’s company! We are able to provide flexibility to team members as needed without diminishing our quality of work." -Kelly, Controller

Melissa O'Dowd
Senior Director, Product Marketing

“There’s so much innovation happening within our walls, new ideas coming into the organization, and a culture that embraces trying new things and continuously improving existing processes. Our start-up type culture within a big company makes it a vibrant place to work.”- Melissa O'Dowd, Senior Director, Product Marketing

Simon Levin
Technical Director

"I work at HealthEdge because it always presents me with new challenges which require professional and personal growth, and such growth is always rewarded by HealthEdge with career advancements and job satisfaction." -Simon, Technical Director

Sarah Clark
VP, Continuous Improvement

“I like working at HealthEdge because I am part of a team that knows how to collaborate, focus on value and continuously improve. I choose HealthEdge because our technology is changing the healthcare industry for the better.” -Sarah, VP, Continuous Improvement

Gail Caldera
Technical Writer

"I love working at HealthEdge because it is a forward-thinking company with a positive and open culture that supports the well-being of the people while providing innovative products that are invaluable. The culture promotes collaboration, teamwork and open communication. Everyone here counts, everyone is heard, and everyone supports eachother to grow and succeed." - Gail, Technical Writer

Marvin Matthews
VP, Project Management and PMO

"I joined HealthEdge to be part of a growing organization that is on a trajectory in becoming the leader in the payer market. The HealthEdge mission and core values were contributing factors for me becoming member of the Professional Services leadership team. As the Leader of the Project Management Team and Project Management Office, I am charged with attaining, retaining, and enabling high performing associates to deliver our next generation solutions to customers in order to support achievement of their strategic business objectives. HealthEdge is vested not only in products and services but talented people, providing an atmosphere of collaboration, innovation, diversity, and fun. Come join my team and be part of this great journey." - Marvin, VP, Project Management and PMO

Dave Paquette
Director, Infrastructure Engineering

"I came to HealthEdge for an unmatched opportunity to further my career in IT with a growing business." -Dave, Director Infrastructure Engineering

Chris Bulkley
VP, Customer Support

"What stands out to me when I'm hiring is a customer-focused drive, a passion for problem solving and a desire to be part of something bigger than themselves." -Chris, VP of Customer Support

Sarang Muralidharan
VP, Solutions Management

“I joined HealthEdge for the opportunity to be part of a growing company that is transforming and modernizing how health plans deliver services to their customers. I am excited to be part of a highly skilled team and look forward to further developing our implementation services and enabling our clients to better compete in the market by taking advantage of the latest tools and features of our products.” -Sarang, VP, Solutions Management

Abe Gutierrez
Technical Account Associate

“HealthEdge's culture is one that makes you feel comfortable to ask questions, where everyone is willing to help” -Abe, Technical Account Associate

Janice Grenda
HR Generalist

"I started at HealthEdge just over 3 years ago as a receptionist and was given chances to learn and grow. I quickly moved into HR where I was given even more opportunities to develop new skills for my career. I love that I am given the chance to use my strengths and overcome my weaknesses too! I am also fortunate to be a part of a great team," - Janice, HR Generalist

Michele Forlenza
Account Executive

“I am really enjoying every aspect of my role and the organization. I love that no matter what you are working on there is no one in the company that isn’t willing to roll up their sleeves and help out. From the top down it really is a team environment.”- Michele Forlenza, Account Executive

Melissa Maulding
Senior Director, Business Consulting Services

"During my interviews, with HE, I experienced the phenomenon that had been described to me. I was excited by the energy of the team/family feeling I experienced. It was very evident that everyone was inspired and dedicated to both the future of the products but also to each other. As well, it was obvious that they were all truly devoted to client success. I knew I wanted to be part of that family and that I wanted to contribute to the overall future success" - Melissa, Senior Director of Business Consulting Services

Danyi Cai
Site Reliability Engineer

“I joined HealthEdge to be part of building a next-generation product in a collaborative environment where innovative ideas are encouraged. I was attracted greatly by the management team and its vision, ambition and approachability.” - Danyi, Site Reliability Engineer

Sandhiya Krishnan
Agile Coach

“As an agile coach, I am glad to be part of a highly skilled team which is open to all the new methods and ideas to make them #1 in the healthcare software market.”- Sandhiya, Agile Coach