Scope of Position
The Business Services Team is part of the MGH Admitting and Registration Services Department and is comprised of operations analysts, project managers, and training specialists. Its goal is to enhance operational practices by leading process improvement initiatives. Under the general direction of the Senior Manager of the Business Services Team, the Revenue Cycle Operations Analyst will be a key contributor on departmental projects; navigating Front End Revenue Cycle operations, providing support on Epic System / Health Information Systems activities, developing functional specifications and business requirements, analyzing data trends and key performance indicators, preparing and executing project plans, and coordinating project implementation. The major focus of this role will be to help structure denial / financial clearance revenue cycle initiatives. The role with interact with multiple Partners Healthcare related revenue groups (i.e. PHS Central Billing Office).
Principal Duties and Responsibilities
Supports project management tasks for all process improvement engagements, with a focus on streamlining front end financial clearance operations.
Functions as a revenue cycle subject matter and front end financial clearance expert, working closely with back end users to develop process improvement solutions utilizing both a qualitative and quantitative analysis process.
Generates weekly and monthly denial reports to perform root cause analysis and help facilitate process improvement initiatives to reduces hospital denials and increase net revenue.
Completes operational functions associated with all financial clearance requirements including work queue management, prior authorization requirements, etc.
Identifies new process improvement projects through data / operations analysis and completion of administrative functions.
Acts as a liaison between the front end and back end billing users to ensure accurate reimbursement is being applied to all MGH hospital accounts.
Attends all PHS and MGH denial / revenue cycle related meetings with the intention of presenting root cause analysis and implementing action plans based off hospital denial trends.
Provides user support for Epic, Huron, and other systems used by departmental staff.
Communicates project status and prepares project documentation as needed (e.g., project plan, status reports, meeting minutes, and project documentation).
Prepares functional design documents and/or technical specifications that meet the needs of the user and are technically feasible. This includes both hardware and software needs assessment and proposals.
Manages the system request changes for Epic application and others as purchased. Provides the management teams with status reports.
Organizes and attends meetings, documenting minutes, key decisions, next steps, and outcomes.
Manages issues, including prioritization, resolution tracking, and communication of critical issues.
Possible projects include but are not limited to: system upgrades and enhancements; capacity management; front-end revenue initiatives including registration and financial clearance processes improvement.
Bachelor’s Degree (Required)
Experienced in EPIC Grand Central / Prelude and Hospital Billing applications, including but not limited to Build, Support, and Operation
Prior work experience in hospital or other healthcare environment
Knowledge of third party payers
Knowledge of ICD-10 and CPT coding (preferred)
2-3 years of experience
Skills and Abilities:
High-quality analytical and problem-solving skills
Exceptional interpersonal and communication skills
Ability to develop relationships and work collaboratively with all levels of hospital employees with attention to detail; customer focus; and a tolerance for ambiguity, changing priorities, and unexpected events
Ability to work both independently and in a cross-functional team environment
Motivated with a high degree of initiative, a quick-learner, and have the capability to manage multiple priorities
Proficiency in personal computer and desktop applications, in particular a command of Microsoft Office applications: Excel, PowerPoint, Visio, Word, and SharePoint
Massachusetts General Hospital is an Equal Opportunity Employer. By embracing diverse skills, perspectives and ideas, we choose to lead. Applications from protected veterans and individuals with disabilities are strongly encouraged.
: MA-Boston-MGH Main Campus
MGH Main Campus
55 Fruit Street
: Massachusetts General Hospital(MGH)
Standard Hours : 40
: Day Job
Recruiting Department : MGH Admitting
: Jul 16, 2018