Denials Liaison

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 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)
* A minimum of 5 years' healthcare experience required
* Revenue cycle or hospital operations related expertise required
* Knowledge of denials prevention preferred

Skills for Success

* Ability to create and interpret complex analytics required
* 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

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.