Senior Revenue Cycle Business Partner
Boston Medical CenterAbout the role
POSITION SUMMARY:
Under the general direction of the Senior Director, Revenue of Cycle Operations, Hospital Billing and Professional Billing and the Senior Manager of Vendor Management, the Senior Revenue Cycle Business Partner (SBO) is responsible for assisting with hospital and professional insurance denials in coordination with revenue cycle, compliance, clinical team members, finance, and others as appropriate. Assists in the review and analysis of system issues and resolves issues with various vendors to improve effectiveness. The SRCA aides with development of departmental policy and coordinates team resources and activities to ensure both HB and PB Revenue cycle meets department goals and KPI’s. The Senior Revenue Cycle Business Partner scrutinizes and creates reports to identify trend and process gaps; identifies and resolves problems for maximum revenue and reimbursement to Boston Medical Center. Assist with implementation and testing of new EPIC WQ’s, system enhancements to optimize processes. Within the appropriate scope of responsibility and span of control, this position also works with various departments, BMC vendor partners and payers to develop the appropriate processes, monitoring controls and reporting to optimize operations. The SRCBP grounds all department activities to help BMC meet its core purpose: Exceptional Care, without exception. Furthermore, the SRCBP supports and exhibits BMC’s three core values: built on respect and empowered by empathy; moves mountains; and many faces create our greatness.
Position: Senior Revenue Cycle Business Partner
Department: PFS Administration
Schedule: Full Time, Quincy MA
ESSENTIAL RESPONSIBILITIES / DUTIES:
General management responsibilities:
Aides with coordination of the HB and PB vendor liaison teams activities to achieve departmental goals for increasing cash collection by lowering insurance denials and patient account receivables.
Interacts with BMC departments and outside vendors and payer representatives to address account resolution barriers.
Documents processes among important internal customers (including but not limited to, Case Management, Patient Access, Registration, Coding, outside vendors), identifies gaps, and recommends changes in policies, processes and procedures to address operational needs and to ensure continuous quality improvement.
Review, monitor, and report on issues identified in Epic dashboards, focusing on claim edits and open account receivable balances.
Performs work queue review to ensure accounts are worked timely and accurately within service level agreements.
Consistently monitors federal, state, and third-party payer regulations and guidelines and conveys updates to all department customers.
Cultivates, maintains, and enhances relationships with third party payers
Demonstrates problem-solving solutions and initiates changes as required.
Develops, monitors, and uses reporting tools, monthly reports, and root cause analyses for denial management and outstanding accounts receivables.
Communicate all denial trends and denial increases to Senior Director and Director in order to positively affect the volume of denials.
Work with ancillary departments’ staff and third party payer provider representatives to identify source of denials and develop processes to eliminate and / or minimize denials and rejections and improve cash flow.
Maintains clear channels of communication for effective problem-solving, as related to denials and write-offs.
Depending on departmental needs the work may shift and the position will need to be able to prioritize and work on multiple assignments.
Assists in the training of employees within the Revenue Integrity denials department.
The Senior Revenue Cycle Business Partner performs all these functions in a manner that complies with standards established by Hospital Administration, Medical Staff, and outside regulatory and accreditation agencies.
Participates in continued learning and possess a willingness and ability to learn and utilize new technology and procedures that continue to develop in their role and throughout the organization
Preform other duties as required
Systems, analysis and reporting
Analyzes data and produces reports to identify areas of focus, account resolution, and the overall effectiveness and efficiency of
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