Revenue Integrity Analyst ll

Title: Revenue Integrity Analyst ll

Location: Somerville United States

Job Description:

Site: Mass General Brigham Incorporated

At Mass General Brigham, we know it takes a surprising range of talented professionals to advance our mission-from doctors, nurses, business people and tech experts, to dedicated researchers and systems analysts. As a not-for-profit organization, Mass General Brigham is committed to supporting patient care, research, teaching, and service to the community. We place great value on being a diverse, equitable and inclusive organization as we aim to reflect the diversity of the patients we serve.

At Mass General Brigham, we believe a diverse set of backgrounds and lived experiences makes us stronger by challenging our assumptions with new perspectives that can drive revolutionary discoveries in medical innovations in research and patient care. Therefore, we invite and welcome applicants from traditionally underrepresented groups in healthcare - people of color, people with disabilities, LGBTQ community, and/or gender expansive, first and second-generation immigrants, veterans, and people from different socioeconomic backgrounds - to apply.

Job Summary

Reporting to the Revenue Integrity Manager, the Revenue Integrity Analyst II plays an important 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, well-developed analytic and organizational skills, and the ability to meet deadlines while influencing, but not directly managing the work of others.

Qualifications

• Provide support for assigned service lines and in collaboration with your team, performs 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 payor requirements.
• 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.
• Leads and participates in moderately complex projects related to revenue cycle initiatives.
• Collaborates with Partners eCare (PeC), Revenue Cycle Operations staff, Compliance, Budget Office, PHS Coding, Internal Audit and other Revenue and Finance departments on revenue management initiatives.
• Analyzes Epic work/error que data and performs root cause analysis. Executes on work plans to correct identified deficiencies. Formally prepares and presents findings in standard presentation for other committees, including leadership.
• 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.
• Coordinate off site cost center meetings with Revenue Integrity team members.
• Attend seminars/webinars on payor regulations and annual code set changes.
• Professional development to include training and support of coding certifications

Qualifications

• Three to five years of experience in a hospital setting or within the healthcare industry preferred.
• Bachelor's degree in finance or science or equivalent combination of education and experience preferred.
• Applicable clinical or professional certifications/licenses such as COC, CPC or AHIMA-CCS are highly desirable.
• Epic healthcare system experience preferred.

Additional Job Details (if applicable)

Remote Type

Remote

Work Location

399 Revolution Drive

Scheduled Weekly Hours

40

Employee Type

Regular

Work Shift

Day (United States of America)

EEO Statement:

Mass General Brigham Incorporated is an Equal Opportunity Employer. By embracing diverse skills, perspectives and ideas, we choose to lead. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment.

Mass General Brigham Competency Framework

At Mass General Brigham, our competency framework defines what effective leadership "looks like" by specifying which behaviors are most critical for successful performance at each job level. The framework is comprised of ten competencies (half People-Focused, half Performance-Focused) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career success. These competencies are used to evaluate performance, make hiring decisions, identify development needs, mobilize employees across our system, and establish a strong talent pipeline.