Denials Liaison

Mass General Brigham•Somerville, MA

1d•$63,648 - $92,570•Remote

About The Position

Under the direction of the Sr. Manager – Denial Prevention & Training, the Denials Liaison is responsible for the execution of denials prevention strategies for the Mass General Brigham enterprise. As a member of the denials prevention team, the Denials Liaison will drive continual improvement efforts to prevent insurance rejections and related write offs. The Denials Liaison is responsible for analysis, interpretation, and identification of insurance denials performance variations and opportunities; recommending process/system improvement initiatives and implementing those initiatives in collaboration with assigned entity Revenue Directors/denials teams. The Denials Liaison will lead assigned prevention initiative workgroups and present updates to RCO and entity leadership. The Denials Liaison collaborates with RCO departments (Financial Analysis, Payer Operations, Payer Contracting, Revenue Integrity, Coding, Finance, Mass General Brigham eCare, and Training). This role requires the ability to work independently, communicate effectively with leadership, excellent analytical skills and expertise in hospital operations and/or revenue cycle operations.

Requirements

Bachelor’s degree required (Business Administration, Healthcare Management and/or Finance degrees preferred)
2+ years of experience in medical billing, coding, or revenue cycle management in a healthcare setting required
Ability to create and interpret complex analytic
Must be an expert in Excel and PowerPoint.
Excellent communication, presentation and interpersonal skills.
Organizes work/ resources to accomplish objectives and meet deadlines
Demonstrates problem-solving skills related to denial analysis
Demonstrates the willingness and ability to work collaboratively with other key internal and external staff, both to obtain necessary information to address denial management issues
Ability to establish contacts and strong working relationships with revenue and administrative leaders across Mass General Brigham entities
Maintains stable performance under pressure, demonstrating sensitivity to diverse organizational cultures
Demonstrates fiscal responsibility by effectively using Mass General Brigham resources

Nice To Haves

Experience in denials management, appeals or other related role preferred

Responsibilities

Utilize knowledge of revenue cycle/hospital operations combined with critical thinking skills to interpret denials data and translating that data into actionable denials prevention strategies
Provide recommendations based on root cause analysis, implementing and tracking the success of approved recommendations across entities and revenue cycle areas
Present updates, findings, and recommendations to internal and external stakeholders/leaders
Manage and facilitate denials prevention workgroups, often leading meetings and providing updates to the Sr. Manager
Track assigned denial prevention efforts, driving progress to completion and alerting the Sr. Manager of delays as appropriate
Work closely with the Financial Analysis team to request additions/changes to reports as needed and assists in data validation