CBO Business Analyst I
Mass General Brigham(PHS)

Job Info

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As a not-for-profit organization, Partners HealthCare 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, Partners HealthCare 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. Partners HealthCare 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 Partners HealthCare 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 Overview

Working under the general direction of the Manager/Director, responsible for analyzing payer Denials, Work Queue Quality and KPI metrics. Working as part of CBO team for PHS process improvement initiatives.

Principal Duties and Responsibilities

Key contributor in a high-profile group responsible for collection of the AR by resolving problems resulting in delayed collection activity.

Operate independently while conducting reviews of high-volume denials both intra and inter departmental to find root cause to influence workflow and process efficiencies.

Develop and create EPIC and payer 'Tip Sheets' designed to support transparent processes across CBO.

Preview and log EPIC E-Care ticket request and Huron change requests.

Participate in projects related to RCO process improvement initiatives

Document and update P&P of CBO Third Party teams.

Execute audits of unit QC and productivity performance in accordance with established policies

Provide elbow support and training of EPIC system functions.

Provide high level support to Director, Manager and Supervisors.

Qualifications
Qualifications

• Bachelors or equivalent experience and training required
• 2-4 years relevant experience in a health care setting desired. Alternative work experience or training in lieu of experience may be considered.

Skills/Abilities/Competencies

• Epic HB, PB and SBO systems proficient experience either due to prior training or through a combination of training classes and peer-to-peer training. Formal training of +20 hours with 6 - 8 weeks of peer to peer training is typical.
• Proficient in Excel and Access highly desired, high intermediate required. Intermediate skills in Outlook, Microsoft Suite and Visio needed to perform all range of assignments.
• Knowledgeable on Third Party Insurance and Medicare Billing Regulations including basic Medicare and Secondary Payer (MSP)..
• Ability to work independently and initiate activities required to complete assignments
• Ability to meet deadlines and excel in a fast-paced environment

• Effective communications, organizational and problem-solving skills

• Ability to manage multiple tasks/projects simultaneously

EEO Statement
Partners HealthCare 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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