Denials Analyst

Requirements

• 2+ years of revenue cycle or denial management experience.
• Strong knowledge of payer requirements, coding, billing regulations, and denial prevention strategies.
• Demonstrated experience in data analysis, report creation, and presenting findings to diverse audiences.
• Proven ability to lead implementation of process improvements and system changes within Epic.
• Epic Resolute Professional Billing, Hospital Billing, Claim Edit experience, or certification preferred.
• Experience working with dashboards and reporting tools such as Clarity, SlicerDicer, Tableau, Quadax, or Power BI.
• Prior experience partnering with clinical service lines on revenue cycle initiatives preferred.

Responsibilities

• Analyze claim denials, identify root causes, and implement sustainable solutions within Epic to reduce future denials.
• Partner closely with service lines, revenue cycle teams, and leadership by presenting denial trends and actionable data while ensuring corrective workflows and system optimizations are put in place.
• Monitor, track, and analyze payer denials within Epic;
• Develop reports, dashboards, and presentations;
• Collaborate with service lines to educate stakeholders on denial drivers and corrective actions;
• Lead denial prevention initiatives through Epic system enhancements, workflow redesign, and implementation of claim edits and rules.
• Partner with revenue integrity, coding, billing, compliance, and IT teams to support denial resolution and prevention strategies, maintain Epic denial workqueues and automation tools, assist with system testing and optimization efforts, provide end-user training, and monitor the effectiveness of implemented solutions.
• Remain current on payer requirements, Epic functionality, and industry best practices to continuously improve clean claim rates, reduce rework, and optimize reimbursement.

We are an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity or expression, pregnancy, age, national origin, disability status, genetic information, protected veteran status, or any other characteristic protected by law.