Revenue Analyst II-(3308103) - Partners Healthcare System

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, Mass General Brigham 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

Under the direct supervision of the Senior Manager, Payer Variance, the Revenue Analyst II supports activities focused on payor payment, various analytics and underpayment recoveries utilizing multiple data base applications. This candidate will actively interact with colleagues, other departments within PHS, and external parties (i.e. Payers) to optimize revenue capture.

Principal Duties and Responsibilities

• Independently and accurately, analyze third party payment variances and determine root cause for discrepancies, utilizing database tools in a timely manner
• Document and submit any necessary appeals to Third Party payers for underpayment recoveries and track for timely response
• Identify overpayments and inform management for purpose of determining financial reserves and remediation of internal processes that may contribute to the discrepancy
• Prepare and present regularreportingof department recoveries (or overpayments) at senior management meetings
• Perform bi-annual contract implementation audit, draft findings and recommendations for Management
• Assist in collection of data and compilation of the regular (may be quarterly but no less than bi-annually) departmental “Variance Activity Report.”
• Represent the Department at payor operations and revenue analyses meetings internally and externally as necessary
• Respond to ad-hoc financial analysis requests independently or in collaboration with other Revenue Finance Departments; respond directly to requestor(s) regarding findings or further inquiries; maintain an accurate up to date tracking log of all ad hoc requests
• Escalate any modeling logic or system issue to Management identified during audit or other analytic work with recommendation for remediation
• Record and monitor payment variances detected independently, or by others within the Department; communicate detected payment variances to internal and external parties
• Serve as the point of contact for clarification on payment variance details, for both internal and external parties
• Participate in the development of any required reporting for use within the Payment Variance team from available database(s)
• Input/correct rates within Harvest modeling system; communicate directly with Harvest vendor regarding the loading of fee schedules, and building specific logic within that database
• Actively participate in process improvement initiatives including, but not limited to the MGB RCO‘ESP – Everyone Solves Problems’ initiative
• Performs other duties as requested

Qualifications

• Bachelor’s degree preferred, with discipline in Healthcare Administration, Management, Finance, Business Administration, or related field
• Minimum of five years prior relevant healthcare experience, billing, financial analysis or revenue cycle experience required

Skills and Abilities for Success

• Possess strong interpersonal skills to effectively communicate with cross functional teams including staff at all levels of the organization
• Ability to successfully negotiate and collaborate with others of different skill sets, backgrounds an levels within and external to the organization
• Strong problem solving and negotiation skills
• Ability to effectively conduct meetings, both formal and informal
• Requires minimal direction from leadership and possesses the ability to learn quickly

Mass General Brigham 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 the law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, perform essential job functions, and receive other benefits and privileges of employment.