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Revenue Cycle Business Partner II

3 months ago

Crown Colony, United States Boston Medical Center Full time

Position:      Revenue Cycle Business Partner  II  

Department: PFS Administration

Schedule: Full Time, Quincy MA

POSITION SUMMARY:

Under the direction of the Senior Manager, Vendor Management, the Revenue Cycle Business Partner II will provide analytical support to resolve various high exposure operating and finance issues across all areas of BOSTON Medical Center and Boston University Medical Group (BUMG).  The Revenue Cycle Business Partner II position requires minimal supervision and is able to work independently and has in-depth knowledge of physician billing, hospital billing, charging workflows, vendor workflows and policies and procedures for the SBO. Monitors regulatory changes and payer requirements for coding and billing and applies this knowledge appropriately in collaboration with appropriate teams.  Due to the service focus and project management emphasis, this position requires strong interpersonal and communication skills, well-developed analytical and organizational skills, and the ability to meet deadlines within a high-pace environment.  Lead large projects and conduct detailed assessments to resolve problems identified by the Senior Manager, Sr. Director and VP. The Revenue Cycle Business Partner II is responsible for identifying and implementing corrective action plans for the processes and systems that leads to lost revenue opportunities and reduced reimbursement for the care provided to patients. The Revenue Cycle Business Partner II acts as a liaison between the Revenue Cycle billing office, third party billing vendor and revenue generating departments and provides advanced analytical support, leads large complex projects and develops detailed resolution plans. Creates a positive, constructive, and supportive relationship between the physician departments, the facility and any other personnel needed to resolve issues.

JOB REQUIREMENTS

EDUCATION:

Bachelor’s degree in Business/Healthcare related field preferred or equivalent combination of formal education and work experience.

CERTIFICATES, LICENSES, REGISTRATIONS REQUIRED:

None

EXPERIENCE:

Associates Degree:  Minimum of seven years of experience in healthcare auditing, coding, finance, revenue cycle management, patient accounting and/or physician billing, preferably in an Academic Medical Center setting.

Bachelor’s Degree:  Minimum of five years of experience in healthcare auditing, coding, finance, revenue cycle management, patient accounting and/or physician billing, preferably in an Academic Medical Center setting.

KNOWLEDGE AND SKILLS:

  • Ability to work independently and possess effective time management skills to permit handling of multiple projects and or tasks
  • Proven advanced level abilities in problem management, process analysis, and root cause analysis
  • Interviewing/listening skills required to enable talking with individuals and groups about current processes and issues to ask the right questions to yield essential information that will be used to evaluate processes and determine potential solutions.
  • Ability to communicate analysis including trends and opportunities to stakeholders both verbally and through writing
  • Excellent organizational and project management skills.
  • Well-developed research skills.
  • Strategic thinker with business acumen.
  • Superior analytical skills to evaluate information gathered from multiple sources and synthesize into actionable information
  • At minimum, intermediate level of proficiency with Window based software, including but not limited to Microsoft Word, Outlook, Excel and PowerPoint
  • Excellent writing, interpersonal and organizational skills
  • Working knowledge of healthcare applications including, but not limited to Epic and nThrive.

ESSENTIAL RESPONSIBILITIES / DUTIES:

  • Responsible for the oversight and completion of the monthly reconciliation of account placements with vendors and validates account level detail on monthly invoices.
  • Provide oversight for assigned physician departments in collaboration with Professional Billing Office Managers, revenue cycle, third party vendor and BUMG Finance and BMC Finance.
  • Monitors current charging and billing processes in physician departments to ensure appropriate capture and resolve issues within workqueues based on system edits.
  • Track charge error trends, patterns and opportunities and develop reporting packet to share findings and make recommendations on long-term resolution in partnership with billing compliance, coding and government and third party payer requirements.
  • Perform necessary actions to work assigned workqueues accurately and within established timeframes.
  • Establish Epic work queue data metrics, and associated root cause analysis.
  • Executes workflow processes to correctly identify deficiencies.
  • Assess the accuracy and build of back-end workflows in EPIC, including workqueue structure, edit accuracy, and follow up workflows and make recommendations on process improvements.
  • Leads and participates in large complex projects related to revenue cycle initiatives.
  • With limited management oversight, develop work plans and lead project timelines for large and complex initiatives to complete assigned projects in the most timely and efficient manner possible.
  • Collaborates with Revenue Cycle Operations staff, Compliance and other Revenue and Finance departments on revenue management initiatives.
  • Provides guidance to senior leadership regarding ongoing vendor performance and opportunities to change vendors or service offerings
  • Act as a team liaison as internal team members perform various assessments, analytical research and support including, but not limited to: root-cause, analyses, cost/benefit analyses, and financial projection for departments based on volume and/or revenue.
  • Provide first tier escalation support to SBO Business Associates, departmental stakeholders, and Revenue Cycle departments, internal and external customers.
  • Collaborate effectively with diverse groups of people and various Revenue cycle and physician departments throughout the organization on revenue improvement initiatives.
  • Maintain professional skills and knowledge through attendance at in-service programs, conferences, workshops and other educational programs and review of current literature.
  • Prepare activity metrics as required.
  • Utilize Hospital's Core Values as the basis for decision making and to facilitate hospital mission.
  • Follow established hospital infection control and safety procedures. Perform other duties as needed and required. IND123

Must adhere to all of BMC’s RESPECT behavioral standards.

(The above statements in this job description are intended to depict the general nature and level of work assigned to the employee(s) in this job.  The above is not intended to represent an exhaustive list of accountable duties and responsibilities required).

Equal Opportunity Employer/Disabled/Veterans