📍 Location: Somerville, MA, US
💼 Type: Fulltime
🏠 Work: Remote
📝 Description: Site: Mass General Brigham Incorporated
Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not\\-for\\-profit, we support patient care, research, teaching, and community service, striving to provide exceptional care. We believe that high\\-performing teams drive groundbreaking medical discoveries and invite all applicants to join us and experience what it means to be part of Mass General Brigham.
**Job Summary**
Reporting to the CDI Senior Director, the MGB CDI Revenue Cycle Liaison works with the CDI, Coding, and Revenue Cycle teams to help mitigate revenue loss and identify revenue preservation opportunities related to clinical documentation. The MGB CDI Revenue Cycle Liaison is responsible for supporting revenue cycle and coding by reviewing and assisting with clinical documentation\\-related denials and appeals. This position examines trends in clinical validation denials, provides education and feedback, and participates in process improvements related to clinical documentation workflow and accuracy. Additionally, this position will serve as liaison between revenue cycle and the CDI vendor to facilitate payor information throughout each fiscal year to ensure accurate CDI financial impact is captured and reported.
Principle Duties and Responsibilities
* Serve as CDI revenue cycle subject matter expert.
* Serve as primary liaison between CDI and revenue cycle, coding, utilization management and case management to address denial risks and other CDI\\-related revenue cycle improvement/preservation initiatives.
* Review payor denials related to clinical documentation and provide clinical support as needed.
* Analyze root causes of denials and identify trends to inform CDI and provider education.
* Act as a primary resource, providing timely and comprehensive responses to revenue cycle and payor\\-related CDI inquiries in both verbal and written formats.
* Serve as primary liaison between revenue cycle and CDI vendor to ensure accurate payor and financial data is incorporated into CDI software.
* Work collaboratively with Coding on process improvement strategies to positively impact revenue cycle and decrease bill hold turnaround time related to CDI workflow.
* Provide support as needed to the Director, CDI Operations and Sr. Manager, Risk Adjustment.
* Support the analysis, tracking, trending, and reporting of CDI\\-related data.
* Maintain professional competence and continuously monitor CDI industry initiatives and trends.
* 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
* Other duties as assigned
**Qualifications**
* Registered Nurse (RN), Advanced Practice Clinician (NP/PA), or other clinically licensed professional
* 5 years of acute medical/surgical care clinical required
* Revenue Cycle Experience preferred
* 5\\-7 years of clinical documentation improvement experience preferred
* Previous CDI experience working closing with revenue cycle and/or denials preferred
* Certification in Clinical Documentation preferred
**Skills, Abilities and Competencies**
* In\\-depth knowledge of clinical disease processes and inpatient care delivery.
* Significant hospital revenue cycle knowledge.
* Advanced understanding of MS\\-DRG/APR\\-DRG logic, SOI/ROM methodology, and CC/MCC assignment.
* Maintain up\\-to\\-date knowledge of inpatient coding guidelines, CDI practices, CMS/OIG regulatory changes, and AHA Coding Clinic.
* Strong foundational understanding of the CDI impact on revenue cycle.
* Strong analytical, critical thinking, and clinical reasoning skills.
* High attention to detail and commitment to accuracy and compliance.
* Excellent written and verbal communication skills.
* Understands the fundamentals of chart review, CDI opportunity, and compliance.
* Ability to create professional presentations and training documents.
Advanced proficiency in Microsoft Office
*
**Additional Job Details (if applicable)**
**Remote Type**
Remote
**Work Location**
399 Revolution Drive
**Scheduled Weekly Hours**
40
**Employee Type**
Regular
**Work Shift**
Day (United States of America)
**Pay Range**
$78,000\\.00 \\- $113,453\\.60/Annual
**Grade**
7
At Mass General Brigham, we believe in recognizing and rewarding the unique value each team member brings to our organization. Our approach to determining base pay is comprehensive, and any offer extended will take into account your skills, relevant experience if applicable, education, certifications and other essential factors. The base pay information provided offers an estimate based on the minimum job qualifications; however, it does not encompass all elements contributing to your total compensation package. In addition to competitive base pay, we offer comprehensive benefits, career advancement opportunities, differentials, premiums and bonuses as applicable and recognition programs designed to celebrate your contributions and support your professional growth. We invite you to apply, and our Talent Acquisition team will provide an overview of your potential compensation and benefits package.
**EEO Statement:**
Mass General Brigham Incorporated is an Equal Opportunity Employer. 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. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. To ensure reasonable accommodation for individuals protected by Section 503 of the Rehabilitation Act of 1973, the Vietnam Veteran’s Readjustment Act of 1974, and Title I of the Americans with Disabilities Act of 1990, applicants who require accommodation in the job application process may contact Human Resources at (857\\)\\-282\\-7642\\.
**Mass General Brigham Competency Framework**
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At Mass General Brigham, our competency framework defines what effective leadership “looks like” by specifying which behaviors are most critical for successful performance at each job level. The framework is comprised of ten competencies (half People\\-Focused, half Performance\\-Focused) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career success. These competencies are used to evaluate performance, make hiring decisions, identify development needs, mobilize employees across our system, and establish a strong talent pipeline.
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