East Boston Neighborhood Health Center Revenue Integrity Analyst in East Boston, Massachusetts
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EBNHC seeking an experienced Revenue Integrity Analyst for remote position! Under the direction of the Manager of Revenue Integrity and Payer Contracting, the Revenue Integrity Analyst will provide analytical support to proactively identify performance trends and propose solutions when needed. This will require an extensive background working with MS Office, with an emphasis on Excel and Presentation programs. The ideal candidate will be a self-starter with broad revenue cycle experience. A key responsibility of this role will be leading projects and assessments prioritized by department leadership. As part of ensuring operational integrity of the revenue cycle processes the position executes steps that support the maintenance and enhancement of all revenue cycle systems. Creates a positive, constructive, and supportive relationship between EBNHC departments, external partners, and personnel needed to resolve issues.
Epic PB Resolute and medical billing experience is required for this position. Strong verbal and written communication skills are needed to be successful in this role.
This position is a 100% remote work opportunity. Proof of residency is required in one of the following States (Massachusetts, New Hampshire, Ohio, Michigan, or Florida).
Essential Duties and Responsibilities:
Communicate and coordinate resolution of identified issues with denials, payment variances and contract operations to leadership and other stakeholders.
Documents department workflow and assists periodic assessments to ensure efficient processes.
Tracks WQ performance to ensure timely processing of claims and proactive identification of billing issues.
Direct and participate in complex projects related to revenue cycle initiatives.
Intermediate analytical skills to evaluate information gathered from multiple sources and synthesize into actionable information
Leads reconciliation for a wide variety of projects. Plays key role in developing reconciliation policies.
Assists with charge master maintenance, including annual updates to ensure appropriate billings and maximization of revenue.
Performs random audits of standard reports and performance measures for all areas of responsibility.
Keeps self and staff abreast of any changes in state and federal government programs, as well as all other third party payers.
Provides feedback to assist EBNHC management in developing strategies to improve patient financial service operations.
Qualifications and Requirements:
Bachelor’s degree or equivalent experience required, Masters Preferred.
3+ years of healthcare experience required, including full scope revenue cycle, charge master, performance benchmarking
3+ years of Epic experience required (PB Resolute)
Knowledge of insurance reimbursement policies, payer contracting, operations and billing regulations
Experience working with Clinic and Physician leadership
Knowledge of health care industry trends
Knowledge of Revenue codes, CPT, and ICD-10 Coding
There’s a reason East Boston Neighborhood Health Center is ranked as one of the “Top Places to Work” by The Boston Globe. It is because we are committed to maintaining a truly supportive and welcoming environment — for both our employees and our patients — that reflects our mission and culture. A huge focus of which is to offer important benefits so you can be your best inside and outside of work.
Striving to be an employer of choice, we offer progressive benefits, a variety of schedules, and the satisfaction of working with a diverse workforce whose unity of purpose is a real force for achievement. Plus, our Education & Training Institute is an attractive resource for many of our employees who seek to broaden their skill base and advance their careers.
Medical & Dental Coverage
Life and Disability Insurance
Privileges at Boston Medical Center for Providers
401(K) Retirement Plan
Flexible Spending & Transportation Accounts
Paid Holidays, Vacations, Sick and Personal Time
A Generous Staff Development Benefit
Excellent Malpractice Coverage
A Designated Medical Staff Office for Physician Support
And Much More…