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0100 Mass General Brigham Incorporated
Denials Liaison
Career Insights for Healthcare Analyst
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What they do
A Healthcare Analyst is responsible for compiling important medical data through the use of computer-based applications, within a health care organization or hospital. Responsible for gathering, compiling, modeling, validating, and analyzing data needed by the organization.
$95,519 / year median in the U.S.
+0% projected growth
Job Description
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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.