Senior Revenue Integrity Analyst

3 weeks ago

Boston, United States Partners Healthcare System Full time

This is a fully remote position, eastern standard business hours.

About Us

As a not-for-profit organization, Mass General Brigham is committed to supporting patient care, research, teaching, and service to the community by leading innovation across our system. Founded by Brigham and Women's Hospital and Massachusetts General Hospital, MGB supports a complete continuum of care including community and specialty hospitals, a managed care organization, a physician network, community health centers, home care and other health-related entities. Several of our hospitals are teaching affiliates of Harvard Medical School, and our system is a national leader in biomedical research.

We're focused on a people-first culture for our system's patients and our professional family. That's why we provide our employees with more ways to achieve their potential. Mass General Brigham is committed to aligning our employees' personal aspirations with projects that match their capabilities and creating a culture that empowers our managers to become trusted mentors. We support each member of our team to own their personal development-and we recognize success at every step.

Our employees use the Mass General Brigham values to govern decisions, actions and behaviors. These values guide how we get our work done: Patients, Affordability, Accountability & Service Commitment, Decisiveness, Innovation & Thoughtful Risk; and how we treat each other: Diversity & Inclusion, Integrity & Respect, Learning, Continuous Improvement & Personal Growth, Teamwork & Collaboration.

The Opportunity

Reporting to the Revenue Integrity Manager, the Senior Revenue Integrity Analyst plays a leadership role and serves as a subject matter expert in a high-profile group tasked with improving revenue results by taking a global view of clinical and financial processes, functions and interdependencies from the provision of patient care to final bill generation. Due to its service focus and project management emphasis, this high visibility position requires strong interpersonal and communication skills, superb analytic and organizational skills, and the ability to meet deadlines and ensure quality deliverables while influencing, but not directly managing the work of others. Senior Analysts are encouraged to lead, coach, and mentor Junior Analysts.

Principal Duties and Responsibilities

* With responsibility for designated service lines and acting with a high degree of autonomy, coordinates reviews related to Charge Description Master (CDM) integrity.
* Implement and standardize charge capture corrective measures and monitoring to ensure effectiveness of changes.
* Assesses the accuracy and build of all charging workflows in EPIC, including documentation, dictionaries, preference lists and other interface or third party charging systems.
* Analyzes financial and clinical indicators to identify and remedy unexpected variances.
* Works with hospital department leadership to implement internal controls when errors are identified.
* Provides MGB Enterprise guidance, communication and education on correct charge capture, coding and billing processes to multiple clinical departments and entities.
* Leads and participates in complex projects related to revenue cycle initiatives. Provides oversight for projects in which support analysts are involved.
* Mentors and coaches assigned analysts and assists in oversight and review of analyst's work.
* Collaborates with Partners eCare(PeC), Revenue Cycle Operations staff, Compliance, Budget Offices, PHS Coding, Internal Audit and other Revenue and Finance departments on revenue management initiatives, across all entities.
* Develops, maintains and implements Revenue Integrity and CDM Management policies, procedures and training materials.
* Analyzes EPIC work/error que data and performs root cause analysis.
* Works independently in a self-directed and collaborative manner.

Qualifications

* Five years of experience in a hospital setting or within the healthcare industry strongly preferred.
* Bachelor's degree required, Masters preferred.
* Applicable clinical or professional certifications/licenses such as CPC, AHIMA-CCS, RN, RT, MT, RPH, PMP are highly desirable.
* Epic healthcare system experience preferred.

Skills/Abilities/Competencies

* Ability to research, analyze and interpret healthcare policies, billing guidelines, and state and federal regulations.
* Full Microsoft Suite applications ability, with strong MS Excel skills required.
* Excellent customer service skills
* Ability to document clinical workflows impacting revenue cycle.
* Strong written communication, formal presentation skills, and excellent customer service skills.
* High degree of comfort presenting to and interacting with senior levels of hospital management and with physician leaders.
* Excellent organizational and project management skills.
* Capacity to manage time effectively, attention to detail, and follow through.
* Motivated individual who can mentor and inspire in a team environment.
* Strong strategic thinker with advanced business acumen.

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