Business Analyst at Mass General Brigham(PHS)

Posted in Other 2 days ago.

Location: Somerville, Massachusetts





Job Description:

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.



General Summary



The Business Analyst performs various functions related to the daily support of Epic claim and remittance processes in Revenue Cycle Operations and is part of a team dedicated to front line support and general process improvements. The incumbent will be responsible for implementing and monitoring organizational and department objectives while ensuring policies and procedures are adhered to. This position will also be responsible for completing and filing of Electronic Data Interchange provider enrollment data and required forms with insurance payers and the Electronic Claims and Remittance Clearinghouse used by Mass General Brigham for claims and electronic remittance advice (ERA) processing. The Analyst will escalate any claim or remittance issue that could potentially affect the revenue cycle to the Operations Team Lead.


Areas of Support Include:


•Epic PB Resolute Revenue Systems


•EDI payor enrollment


•Claim production


•Remittance production


•Other complementary applications



Duties & Responsibilities



  • Use/s 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

  • Work directly with various EDI Clearinghouse(s) and other direct payor support staff to ensure all EDI electronic remittance advice (ERA) and claim enrollment requirements are completed

  • Prepares and files EDI enrollment forms and paperwork with insurance payer and the Electronic Data Interchange clearinghouse

  • Responsible for forming a business relationship with healthcare insurance payers and their EDI support departments

  • Responsible for cross training and coverage of analyst tasks and responsibilities

  • Responsible for troubleshooting and participate in the resolution of all claim and payment issues with a focus on enrollment resolutions

  • Recognizes, communicates, and raises concerns relevant to critical path and/or timeline of issues in a timely manner

  • Participate in special projects as needed including new business onboarding and payer EDI enrollment

  • Manages and triages the requests that are submitted via Mass General Brigham Service Now application

  • Develops and maintains models of business and system requirements

  • Documents and updates business processes in relevant areas as needed

  • Attends weekly team meetings to discuss team and project related activities, issues, change, communications, and updates

  • Support Business process improvement (workflows) to optimize system use

  • Support and follow Policies and Procedures

  • Completes specific tasks as directed

  • Other duties as assigned

  • This position is currently remote. May be required, on occasion to travel into the office due to business needs.

  • Possible local travel to Mass General Brigham sites.






Qualifications

Qualifications



  • A combination of education and experience may be substituted for requirements

  • Bachelor's Degree preferred, however, relevant applicable work experience can be substituted

  • 3 years related experience, including experience in a healthcare environment, Electronic Data Interchange or general business/financial/accounting experience

  • Some understanding of revenue cycle workflow relevant to healthcare claims and payment principles


Skills/ Competencies



  • Possess strong interpersonal skills to effectively communicate with cross functional teams including staff at all levels of the organization

  • Ability to successfully negotiate and collaborate with others of different skill sets, backgrounds and levels within and external to the organization

  • Strong problem solving and negotiation skills

  • Ability to effectively conduct meetings, both formal and informal

  • Requires minimal direction from leadership and possesses the ability to learn quickly

  • Strong verbal and written communication skills

  • Strong problem-solving skills

  • Self-motivated, independent and possesses the ability to learn quickly

  • Ability to assimilate and understand new software releases and succeed in a changing environment

  • Ability to review project deliverables for completeness, quality, and compliance with established project standards

  • Ability to document and communicate the status of progress against plans, taking corrective action as necessary

  • Ability to understand the work environment and competing priorities in conjunction with developing/meeting project goals

  • Ability to plan and prioritize tasks accordingly

  • Strong PC skills required






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.
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