Denials Liaison

Site: Mass General Brigham Incorporated

Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit, we support patient care, research, teaching, and community service, striving to provide exceptional care. We believe that high-performing teams drive groundbreaking medical discoveries and invite all applicants to join us and experience what it means to be part of Mass General Brigham.

Job Summary

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.

• 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

  Qualifications

  • 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

  • Experience in denials management, appeals or other related role preferred

  Knowledge, Skills and Abilities

  • 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 Fiscal Duties Demonstrates fiscal responsibility by effectively using Mass General Brigham resources

  Working Schedule:

  • Remote, M-F eastern standard business hours. Requires a quiet, secure, HIPAA-compliant working station

  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)

  Pay Range

  $63,648.00 - $92,570.40/Annual

  Grade

  6At 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.

  EEO Statement:

  0100 Mass General Brigham Incorporated is an Equal Opportunity Employer. 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. To ensure reasonable accommodation for individuals protected by Section 503 of the Rehabilitation Act of 1973, the Vietnam Veteran’s Readjustment Act of 1974, and Title I of the Americans with Disabilities Act of 1990, applicants who require accommodation in the job application process may contact Human Resources at (857)-282-7642.

  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.