Professional Revenue Cycle Account Manager

MassachusettsGeneral Hospital is an Equal Opportunity Employer. By embracing diverse skills perspectives and ideas wechoose to lead. Applications fromprotected veterans and individuals withdisabilities are strongly encouraged.

Proficiency in Microsoft Office suite (Excel Word Access Outlook)required IDX (or similar) system(s) preferred

Ability to present to multiple levels of staff from VPs to Ads toManagers to providers to Billing Managers to front desk staff

Define problems collect data establish facts and draw validconclusions

Proficiency in Microsoft Office suite (Excel Word Access Outlook)required

The Billing Manager has no direct reports however he/she is responsiblefor mentoring and providing some daytoday supervision of the AssistantBilling Managers and/or Fiscal Liaisons who are assigned to work withhim/her

The fiscal responsibility varies based on the practice (s) covered by theindividual Billing Manager

The MGPO Professional Billing Office is located in the Charlestown Navy Yardcampus

The hours are usually Monday through Friday 8:00 AM to 4:30 PM but varyaccording to the demands on this exempt salaried position

Staff is very collaborative and work together to solve issues withparticular practice issues

There are often multiple conversations occurring at the same time thestaff needs to be able to handle an environment that is not quiet

Working under the general direction of the Associate Director OperationsManager and Team Leads of the Group Practice Management department (GPM) inthe Professional Billing Office (PBO) the Billing Manager serves as theprimary contact between a group practice and the PBO for all aspects relatingto the billing of professional services. Working closely with theAdministrative Director and physician leadership of a practice the BillingManager is responsible for the proactive management of the billing process andthe client relationship full assessment and understanding of the practicesrevenue cycle which includes a thorough understanding of systems process andservice specific coding and billing requirements proactively identifyingopportunities for revenue cycle improvement initiatives and developing andexecuting these plans providing practice and PBO Management with interpretationof standard operational financial billing and budget statistics on a monthlybasis. The MGPO Professional Billing Office is the central billing officefor physician practices affiliated with Massachusetts General Hospital inBoston Massachusetts.

Establishes and manages effective ongoing communication with assigned physician practice(s) to identify and address business needs; provides guidance and timely responses to customer service questions and requests; conducts regular meetings with practice staff. Communicates with practice(s) within the framework of the Revenue Cycle. Provides analysis and context for monthly performance data. This includes projections and comparison to budget figures. Provides analysis and context for monthly performance data

Effectively manages group or practices expectations regarding financial performance. Maintains ongoing issues and priority list for practice/PBO. Completes analysis of issues for action presents this information and implements or supervises action plans. Prioritizes with practice MDs or Directors on key performance issues. Proactively identifies sources of issues and communicates these to the appropriate parties. Provides practice(s) with updates on new initiatives within the PBO designed to improve billing performance

Assists practice with statistical analysis. Consults with Management Team to identify issues and trends that contribute to variances and below par performances. Makes recommendations to address issues

Provides practice(s)/PBO Management Team with statistical reports including but not limited to:

• total copayment collections
• total encounter discrepancies
• interface edits
• service to post date lag time
• charges held due to provider credentialing
• number of missing referrals
• number of cash deposit discrepancies
• number of outstanding provider applications
• monthly writeoffs
• payer rejections

Understands the implication of each element in the revenue cycle communicates this to group/practice to engender an appropriate response. Provides interpretation to clients/PBO Management. Develops interventions and initiates actions

Focuses practice(s) on issues that will positively impact financial performance. Provides updates on global issues regarding coding and reimbursement practice(s). Assesses impact of new regulations or codes from a coding compliance and reimbursement perspective. Develops expertise for assigned practice(s). Works with practice leadership on annual budgeting forecasting and analysis for potential new business opportunities

Supports the integration of new physicians/practice(s) into the PBO by providing professional charges by CPT code to MIS for dictionary modifications; assisting in the orientation/training of practice staff (i.e. batch processing time of service payments referral management copay collection discrepancy management and overall PBO structure/operations. Demonstrates understanding of group division and billing area structure within IDX. Points out particular issues that could arise in implementation of billing services for the MD or practice. Ensures that all implementation tasks are completed accurately and in a timely fashion. Does periodic quality assurance checks to ensure that process is running as expected

Establishes and develops collaborative relationships with internal staff. Works with PBO departments to modify procedures (i.e. Batch Control charge entry procedures) and update information (i.e. update encounter forms billing instructions). Shares information with PBO staff to enhance departmental efficiency/performance (i.e. notifies ADs of audit and compliance risks identifies issues through rejection or receivable analysis. Provides backup assistance to departments in need

Represents functional areas within PBO as collaborative areas of practices billing team. When requesting specific assistance from a functional area provides detailed summary of request with supportive data. Upon identification of issues researches issue to determine whether it is an isolated instance or a trend and follows up with the Group Practice Manager and AD to facilitate communication to all parties within Group Management the practice and the PBO

Develops standardized approaches for operational issues reporting analysis and quality management. Reviews key measures on a regular basis and develops new measures as needed. Develops expertise in querying system for data and reports. Works closely on interface and system issues as required to improve flow of data

Participates in committees and task forces as assigned