Denials Liaison
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AI Summary
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
Work Location
Scheduled Weekly Hours
Employee Type
Work Shift
Pay Range
$63,648.00 - $92,570.40/Annual
Grade
6
EEO Statement:
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.
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