Revenue Specialist

2 weeks ago

Boston, United States Partners Healthcare System Full time

General Summary/ Overview:

The Revenue Specialist is responsible for supporting the MGB Medical Group (medical group) on all essential patient facing activities, such as registration, insurance verification, collections, and charge capture. The Revenue Specialist is also responsible for identifying, scoping, and implementing revenue generating initiatives which includes workflow development, analyzing data, and report out of metrics.

Principal Duties and Responsibilities:

Leadership Impact and Problem Solving:

● Support the Revenue Optimization Senior Manager as a liaison between the medical group and Revenue Cycle Account Managers (RCAM) for consultation on front end charging workflows, collections, and new business lines.

● Serve as a subject matter expert on patient facing workflows that impact revenue cycle performance, such as registration, payer guidance on scheduling, insurance verification, check-in efficiencies.

● Collaborate with medical group practice operations and leadership to identify, prioritize, and implement revenue generating projects.

● Align revenue goals and activities with Group Practice Management (GPM) leadership and RCAMs to present a unified and supportive team to the medical group practices.

Operational Performance:

● Takes a leading role in the project management, design, and implementation of new revenue generating initiatives for the medical group.

● Monitors performance of various revenue projects through observations, audits, data analysis and operational reporting to achieve and sustain operational goals.

● Assist in development of best practice and standard work for front end practice staff.

● Coordinate or consult on roll out of new front-end features that can enhance revenue performance. (i.e. Fast pass, open and direct scheduling, kiosk installation, new visit types)

● Collaborate with medical group practice operations teams and other MGB leaders on centralized revenue opportunities. (i.e. TCMs, CCM, AWV outreach)

● Implement mechanisms to ensure charges are reconciled for each medical group practice. Raise enhancement requests, where possible, to automate charge capture in EPIC.

● Along with MGB Coding and Compliance teams, organize or conduct charge capture trainings, as needed, and communicate broadly when a new service or coding opportunity arises.

● Maintenance of No Surprise Billing (NSB) and self-pay collections workflows and guides, where applicable.

● Partner with medical group training teams to ensure front end staff have the necessary tools and tipsheets to adequately perform their revenue cycle duties. Provide in-service sessions with medical group staff, as needed.

● Collaborate with other RCO teams across enterprise, such as, Financial Clearance and Patient Financial Experience to secure revenue for ambulatory services.

Financial Performance:

● Oversee the process of collecting and organizing analytical data related to the medical group's revenue opportunities.

● Provide oversight on report distribution, tracking progress on revenue optimization projects, and report out of metrics to medical group leadership.

● Other duties as assigned.

Qualifications:

Education

* Bachelor's degree, in Finance, Healthcare, or Business-related field, required or equivalent work experience to support role.* Master's Degree, preferred.

Work Experience

* At least 3-5 years of related health care business experience. Emphasis on revenue cycle, practice operations, reimbursement, customer service, and financial analysis required.* EPIC experience, preferred.* Understanding of CPT codes, ICD-10, and reimbursement of services, preferred.

Skills/Abilities/Competencies:

* Proficiency in Microsoft Office suite (Excel, Word, Access, Outlook) required.* Must be able to demonstrate effective written and verbal communication skills, as well as training and facilitation skills.* Strong people skills required; ability to listen effectively with discernment and understanding required.* Excellent problem solving and decision-making skills required.* Proven ability to work with minimal direction, exercise good judgment, and achieve results across RCO and medical group.* Outstanding ability to identify, prioritize and resolve critical issues efficiently and effectively.* Effectively and confidently present ideas and information to a variety of audiences and to all levels of management.* Proven customer service orientation.* Ability to develop and achieve goals and deadlines.* Manage multiple priorities and succeed in a fast paced, rapidly changing environment.

Supervisory Responsibilities:

* No direct reports

Fiscal Responsibility:

* No direct budgetary responsibility.* Demonstrates fiscal responsibility by effectively using Mass General Brigham resources.

Working Conditions:

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job.

* This position is remote.* Normal office working conditions. The noise level in the work environment is quiet to moderate.

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