Revenue Cycle Account Manager, Community & Specialty Oversight

Massachusetts General Hospital; Somerville (MA); Hybrid; USD 70,000 - 90,000; Full time

Job summary

Massachusetts General Hospital seeks a Revenue Cycle Account Manager to manage revenue cycle processes and communication between hospital sites. This role requires expertise in healthcare billing, analytical skills, and experience in a professional healthcare environment. The chosen candidate will develop initiatives, perform financial analyses, and ensure operational efficiencies to enhance revenue capture.

Qualifications

• Bachelor's degree strongly preferred or equivalent experience required.
• Minimum of 3 years' experience in a professional healthcare setting required.
• Proficiency in Microsoft Office suite required, EPIC preferred.

Responsibilities

• Manages communication with assigned sites to identify business needs and provides guidance.
• Monitors site activity utilizing EPIC Dashboards and ensures compliance with service standards.
• Develops initiatives for operational issues and provides statistical reports for site leadership.

Skills

Healthcare billing

Finance principles

Data analysis

Communication

Presentation skills

Education

Bachelor's degree

Tools

EPIC

Microsoft Office

Job description

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

General Summary/ Overview:

Working under the general direction of the RCO Revenue Manager, the Revenue Cycle Account Manager serves as the primary contact between designated hospital sites and practices and the RCO for all aspects relating to hospital revenue cycle. Working closely with hospital, practice, and site leadership, the RCAM is responsible for the proactive management and full assessment and understanding of the hospital revenue cycle. This includes understanding systems, processes, service-specific coding, billing requirements, and identifying opportunities for revenue cycle improvement. Develops and implements initiatives, new service setup and provides practices and RCO Management with monthly status updates and analyses of standard operational, financial, billing, and budget statistics.

Principal Duties and Responsibilities:

• Establishes and manages effective ongoing communication with assigned site(s) to identify and address business needs; provides guidance and timely responses to customer service questions and requests; conducts regular meetings with site staff. Communicates with site(s) within the framework of the Revenue Cycle. Provides analysis and context for monthly performance data. This includes projections and comparison to budget figures.
• Maintains ongoing issues and priority list for site. Completes analysis of issues for action, presents this information and implements or supervises action plans. Prioritizes initiatives with site leaders or directors on key performance issues. Proactively identifies sources of issues and communicates these to the appropriate parties. Provides site(s) with updates on new initiatives within the RCO designed to improve revenue capture and billing performance.
• Assists site with statistical analysis. Consults with Management Team to identify issues and trends that contribute to variances in expected performance. Makes recommendations to address issues.
• Provides site(s)/ leadership Team with statistical reports and analysis.
• Focuses site(s) on issues that will positively impact financial performance. Provides updates on global issues regarding coding and reimbursement. Assesses impact of new regulations or codes from a coding, compliance, and reimbursement perspective. Develops expertise for assigned site(s). Works with site leadership on annual budgeting, forecasting, and analysis for potential new business opportunities.
• Supports the integration of new providers/practice(s) by providing data to DHeC for dictionary modifications, assisting in the orientation/training of site staff (coordinating with credentialing staff, Cadence, Ambulatory, Patient Service Center, DHeC team. Monitors time of service payments, referral/authorization management, co-pay collection, discrepancy management, and overall revenue structure and operations). Demonstrates understanding of department, division, and cost center structure within EPIC. Points out issues that could arise in implementation of billing services for the hospital or site. Ensures that all implementation tasks are executed with precision and within the designated timeframe. Does periodic quality assurance checks to ensure that process is running as expected.
• Establishes and develops collaborative relationships with internal staff. Works with departments to modify procedures and update information (i.e., update preference lists, billing instructions). Shares information with RCO staff to enhance departmental efficiency/performance (i.e., notifies appropriate leaders of audit and compliance risks, identifies issues through denial or receivable analysis). Provides back-up assistance to departments in need.
• Develops standardized approaches for operational issues, reporting, analysis, and quality management. Reviews key measures on a regular basis and develops new measures as needed. Develops expertise in querying system for data and reports. Works closely on interface and system issues as required to improve flow of data.
• Monitors site activity utilizing EPIC Dashboards, Workqueues and reports. Ensures that charge and account receivables processing meet established service standards and works with MBG Patient Billing Solutions to efficiently resolve self-pay issues and patient concerns.
• Attends all department and site meetings as required.
• Works collaboratively with Patient Financial Services, Registration, Patient Service Center, Coding, Payer Relations and their counterparts on the Revenue Integrity Team to ensure efficient processing and follow up on all revenue matters.
• Participates in committees and task forces as assigned.
• Additional responsibilities may be assigned as needed

Qualifications

Qualifications:

• Bachelor's degree strongly preferred or equivalent experience required
• Minimum of 3 years' experience in a professional healthcare setting required
• Proficiency in Microsoft Office suite (Excel, Word, Access, Outlook) required, EPIC, preferred
• Ability to learn and assimilate electronic systems
• Prior experience working in hospital revenue operations preferred

Skills/Abilities/Competencies:

• Understanding of healthcare billing, finance, and accounting principals
• Motivated to achieve Service Excellence
• Capacity to manage multiple tasks at the same time effectively.
• Requires excellent oral and written communications skills
• Ability to present to multiple levels of staff from VPs, to ADs, to Managers, to providers, to Billing Managers, to front desk staff
• Define problems, collect data, establish facts, and draw valid conclusions
• Ability to conduct training sessions
• Proficiency in Microsoft Office suite (Excel, Word, Access, and Outlook) required

Supervisory Responsibilities:

• No direct reports; provides leadership and guidance to less seasoned and new staff.

Fiscal Responsibility:

• The fiscal responsibility varies based on the site(s) covered by the individual Revenue Cycle Account Manager
• Demonstrates fiscal responsibility by effectively using Mass General Brigham resources.

Working Conditions:

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job.

• This position is Remote but with the expectation that folks will be asked to come into the office, on average, once per quarter for up to 4 business days (travel will be reimbursed per MGB policy).
• Hospital work environment working conditions include possible exposure to diseases or infections and may require safety gear (PPE) such as gloves and mask.
• Normal office working conditions. The noise level in the work environment is quiet to moderate.
• While performing the duties of this job, the employee is frequently required to sit; talk; or hear; use hands to finger; handle; or feel; reach with hands and arms. The employee is occasionally required to stand; walk; and stoop; kneel; or crouch. The employee must frequently lift and/or move up to 5 pounds and occasionally lift and/or move up to 20 pounds.
• Specific vision abilities required by this job include close vision, distance vision and depth perception.

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)

EEO Statement:

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.