Restructuring and Turnaround Services, Healthcare and Life Sciences - Senior Associate (Revenue Cycle Management)

About the role

You will serve as a subject matter resource on revenue cycle management, reimbursement analytics, denial management, and payer contract performance across a diverse client portfolio spanning healthcare providers and payers.

Responsibilities

• Leverage deep functional expertise to analyze complex financial and operational data, surface underpayment and denial trends, evaluate payer contract compliance, and deliver actionable recommendations that drive measurable improvements in net revenue and cash performance.
• Own analytical workstreams, contribute directly to client-facing deliverables, and serve as a knowledgeable resource on reimbursement methodology, denial root cause analysis, and payer behavior across commercial, Medicare, and Medicaid lines of business.

Requirements

• Hold a Bachelor’s degree in Finance, Accounting, Health Administration, Health Information Management, or a related field; a Master’s degree is a plus.
• Minimum of 3 years of hands-on experience in provider and/or payer analytics, with a strong track record in reimbursement analysis, denial management, underpayment identification, and payer contract evaluation.
• Possess extensive knowledge of commercial, Medicare, and Medicaid reimbursement methodologies, fee schedules, and payment structures, including DRG, APC, RBRVS, and value-based payment models.
• Deep expertise in denial management — including denial categorization, root cause analysis, trending, and appeals — with the ability to design denial prevention strategies and quantify financial impact.
• Demonstrated experience identifying and recovering underpayments through systematic contract modeling, remittance auditing, and payer comparison analysis.
• Proficient in payer contract analysis, including rate modeling, reimbursement adequacy assessment, and identification of contractual versus non-contractual variances.
• Highly proficient in Microsoft Excel for complex financial modeling, and experienced with data analytics tools such as Power BI, Tableau, SQL, or comparable platforms used in RCM analytics environments.
• Familiarity with at least one major EHR or practice management system (e.g., EPIC, Cerner, Athenahealth) and clearinghouse/claims data environments.
• Knowledge of CPT, ICD-10, HCPCS, and revenue code conventions as they relate to billing accuracy and reimbursement outcomes.
• Communicate complex findings clearly and confidently, both in written deliverables and in verbal presentations to client stakeholders.
• Experience working across both provider and payer environments, with the ability to interpret claims data and adjudication logic from multiple perspectives.
• Familiarity with value-based care reimbursement models, shared savings arrangements, or risk-based contracting structures.
• Experience with RCM technology platforms, clearinghouses, or denial management software (e.g., Waystar, Change Healthcare, Optum360).
• Knowledge of HIPAA compliance, healthcare data privacy standards, and audit response protocols.
• Prior experience in a consulting, advisory, or professional services environment.

Qualifications

• Minimum of 3 years of hands-on experience in provider and/or payer analytics, with a strong track record in reimbursement analysis, denial management, underpayment identification, and payer contract evaluation.
• Extensive knowledge of commercial, Medicare, and Medicaid reimbursement methodologies, fee schedules, and payment structures, including DRG, APC, RBRVS, and value-based payment models.
• Deep expertise in denial management — including denial categorization, root cause analysis, trending, and appeals — with the ability to design denial prevention strategies and quantify financial impact.
• Demonstrated experience identifying and recovering underpayments through systematic contract modeling, remittance auditing, and payer comparison analysis.
• Proficiency in payer contract analysis, including rate modeling, reimbursement adequacy assessment, and identification of contractual versus non-contractual variances.
• High proficiency in Microsoft Excel for complex financial modeling, and experience with data analytics tools such as Power BI, Tableau, SQL, or comparable platforms used in RCM analytics environments.
• Familiarity with at least one major EHR or practice management system (e.g., EPIC, Cerner, Athenahealth) and clearinghouse/claims data environments.
• Knowledge of CPT, ICD-10, HCPCS, and revenue code conventions as they relate to billing accuracy and reimbursement outcomes.
• Experience working across both provider and payer environments, with the ability to interpret claims data and adjudication logic from multiple perspectives.
• Familiarity with value-based care reimbursement models, shared savings arrangements, or risk-based contracting structures.
• Experience with RCM technology platforms, clearinghouses, or denial management software (e.g., Waystar, Change Healthcare, Optum360).
• Knowledge of HIPAA compliance, healthcare data privacy standards, and audit response protocols.
• Prior experience in a consulting, advisory, or professional services environment.

Skills

• Microsoft Excel
• Data analytics tools (Power BI, Tableau, SQL)
• EHR/Practice management systems (EPIC, Cerner, Athenahealth)
• Clear communication skills
• Interpretation of claims data and adjudication logic
• Value-based care reimbursement models
• RCM technology platforms, clearinghouses, or denial management software

Benefits

Full-time roles are eligible for a full range of benefits including medical, dental, and vision insurance, 401(k) with company match, and PTO. A complete description of all available benefits can be found at Riveron's Benefits page at https://riveron.com/riveron-life/.

Pay

$90K - $145K

Schedule

Full-time