Senior Revenue Cycle Business Partner

Role Description

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. The Senior Revenue Cycle Business Partner scrutinizes and creates reports to identify trends and process gaps; identifies and resolves problems for maximum revenue and reimbursement to Boston Medical Center.

• 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, identifies gaps, and recommends changes in policies, processes, and procedures to address operational needs.
• 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.
• Communicates all denial trends and denial increases to Senior Director and Director.
• Works with ancillary departments’ staff and third-party payer provider representatives to identify sources of denials and develop processes to eliminate and/or minimize denials and rejections.
• Maintains clear channels of communication for effective problem-solving related to denials and write-offs.
• Assists in the training of employees within the Revenue Integrity denials department.
• Participates in continued learning and possesses a willingness and ability to learn and utilize new technology and procedures.
• Performs other duties as required.

Qualifications

• Bachelor’s degree in Business/Healthcare related field preferred or equivalent combination of formal education and work experience.
• Minimum of five years of experience related to healthcare finance and Revenue Cycle management required, preferably in an Academic Medical Center setting.
• Requires an extensive knowledge of policies, procedures, systems, and equipment relating to revenue cycle operations.
• Requires the ability to develop policies, procedures, processes, and programs; to analyze data and interpret statistics.

Requirements

• Work requires interpersonal skills necessary in team building endeavors.
• Ability to work independently and possess effective time management skills.
• Proven advanced level abilities in problem management, process analysis, and root cause analysis.
• Ability to communicate analysis including trends and opportunities to stakeholders both verbally and through writing.
• At minimum, intermediate level of proficiency with Windows-based software, including Microsoft Word, Outlook, Excel, and PowerPoint.
• Excellent organizational and project management skills.
• Strategic thinker with business acumen.
• Working knowledge of healthcare applications including Epic and nThrive.

Benefits

• Compensation Range: $78,000.00 - $113,000.00.
• Generous total compensation that includes benefits (medical, dental, vision, pharmacy).
• Discretionary annual bonuses and merit increases.
• Flexible Spending Accounts.
• 403(b) savings matches.
• Paid time off.
• Career advancement opportunities.
• Resources to support employee and family well-being.