Job SummaryReporting to the Revenue Integrity Manager, the Senior Revenue Integrity Analyst plays a leadership role 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 position requires strong interpersonal and communication skills, superb analytic and organizational skills, and the ability to meet deadlines while influencing, but not directly managing the work of others.
Essential Functions:
• With responsibility for designated service lines and acting with a high degree of autonomy, coordinates reviews related to Charge Description Master (CDM) integrity.
• Evaluates current charging and coding structures and processes in clinical departments to ensure appropriate capture and reporting of revenue and compliance with government and third-party payer requirements, to ensure consistency across all entities.
• Analyzes changes to coding and billing rules and regulations by utilizing appropriate reference materials, internet sources, seminars and publications. Executes on work plans to adapt systems and processes to accommodate changes. Formally prepares and presents findings in standard presentation for other committees, including leadership.
• Assesses the accuracy and build of all charging workflows in EPIC, including documentation, dictionaries, preference lists and other interface or third party charging systems.
• Provides PHS 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 queue data and performs root cause analysis. Executes on work plans to correct identified deficiencies.
QualificationsEducation- Bachelor's Degree Finance, Accounting, Healthcare Administration, or related field of study required. Equivalent experience may be accepted in lieu of degree
Experience- 3+ years of experience in revenue cycle analysis, billing, claims processing, or financial analysis in a healthcare setting required
- Pharmacy experience preferred
Knowledge, Skills and Abilities- 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.
Additional Job Details (if applicable)• M-F Eastern Business hours required for remote role
• A quiet, secure, stable, HIPPA-compliant workstation is required.
Remote TypeRemote
Work Location399 Revolution Drive
Scheduled Weekly Hours40
Employee TypeRegular
Work ShiftDay (United States of America)
Pay Range$79,560.00 - $115,720.80/Annual
Grade7
At Mass General Brigham, we believe in recognizing and rewarding the unique value each team member brings to our organization. Our approach to determining base pay is comprehensive, and any offer extended will take into account your skills, relevant experience if applicable, education, certifications and other essential factors. The base pay information provided offers an estimate based on the minimum job qualifications; however, it does not encompass all elements contributing to your total compensation package. In addition to competitive base pay, we offer comprehensive benefits, career advancement opportunities, differentials, premiums and bonuses as applicable and recognition programs designed to celebrate your contributions and support your professional growth. We invite you to apply, and our Talent Acquisition team will provide an overview of your potential compensation and benefits package.
