Job Info
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
The coordinator functions under the general supervision of the Specialty Billing Department Supervisor. This position is responsible for the receivable for all MGB facilities in Epic.
The coordinator must be able to perform in a high volume and fast paced production environment with a high degree of accuracy and productivity including the difficult exception claims that occur. This individual should have the ability to take responsibility and perform required tasks independently as well as in a team environment.
Principal Duties and Responsibilities
- Works Directly out of the EPIC system
- Reviews assigned accounts by contacting specialty billing payers and patients to ensure timely resolution of accounts
- Coordinate daily workflow and work with all team members to ensure daily productivity targets and goals are met.
- Serve as escalation point for staff to report issues/problems.
- Effective billing and follow up for timely charge review and claims submission in addition to no response, denial and appeal follow up, minimizing account touches.
- Create updates and document information relating to the financial status of accounts in the revenue cycle billing systems.
- Calculate payable portion per applicable contract and utilize available tools to secure proper payment from payer. This includes contacting payer as needed and reviewing contract and billing terms.
- Uses root cause analysis and translates day to day issues into specific and actionable resolution steps.
- Works in conjunction with Supervisor on challenging issues and develops timely resolution
- Assists in the training of new and existing employees
- Communicate effectively with other MGB employees through the enterprise
- Performs all other duties and assignments as requested
Qualifications Qualifications• High school diploma or equivalent required
• Five years previous patient accounting experience required
• Thorough knowledge and understanding of electronic HIPAA transactions including 837 claim files and fields as well as 835 Remit files and fields
• Thorough knowledge and understanding of UB04 and 1500 claim forms and data fields
• Thorough knowledge and understanding of ANSI standards for claim requirements/submission
• Robust knowledge of Hospital, Payer, and industry rules and requirements
Skills/Abilities/Competencies • Strong interpersonal skills required
• Ability to effectively communicate with employees throughout the MGB network
• Ability to identify problems and issues within daily bill drops and research, review, and analyze for systems reporting
• Strong understanding of Excel and Access is required
• Expert knowledge of hospital billing required
• Attention to detail a must
• Ability to multi-task required
• Accurately and productively perform high volume output on a daily basis
• Expert experience with hospital billing systems is required
Schedule
- Shifts are between 7a-5p ET required
- Hybrid Working model at Assembly Row Somerville, weekly onsite planned days, and remote work requires stable, secure, quiet, compliant work area.
EEO Statement 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 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.