Rev Cycle Denials Analyst

Overview

Be inspired . Be rewarded. Belong. At Emory Healthcare.

At Emory Healthcare we fuel your professional journey with better benefits valuable resources ongoing mentorship and leadership programs for all types of jobs and a supportive environment that enables you to reach new heights in your career and be what you want to be . We provide:

• Comprehensive health benefits that start day 1

• Student Loan Repayment Assistance & Reimbursement Programs

• Family-focused benefits

• Wellness incentives

• Ongoing mentorship development and leadership programs

• And more

Description

RESPONSIBILITIES:

• The System Denials Analyst is responsible for gathering analyzing and reporting data related to both hospital and professional billing denials across the healthcare system.
• Reporting to the Director of Enterprise Denial Management this role provides critical insights into denial trends and patterns by pulling data from various sources identifying areas for process improvement and supporting efforts to optimize the organizations revenue cycle performance.
• The position focuses on data accuracy trend analysis and preparing reports to assist leadership in making data-driven decisions to reduce denials and improve overall Data Collection and Reporting
• Gather and compile denial data from multiple systems for both hospital and professional billing.
• Ensure data accuracy and completeness before generating reports.
• Trend & Root Cause Analysis:
• Analyze denial patterns to identify root causes collaborating with cross-functional teams to implement strategies that prevent future denials.
• Process Improvement Support:
• Support the denial management team by providing data insights that inform process improvement initiatives aimed at reducing denial rates.
• Regulatory Compliance:
• Ensure all denial management activities comply with federal state and payer-specific regulations.
• Cross Functional Collaboration:
• Work closely with departments such as Billing Coding and Case Management to streamline processes and improve communication.
• Reporting Tools:
• Develop and maintain denial dashboards ensuring that reporting tools are accurate up-to-date and aligned with organizational needs.
• Data Integrity:
• Ensure data integrity in all reporting efforts reconciling discrepancies and resolving data quality issues as needed.
• Stakeholder Communication:
• Prepare and deliver reports and presentations on denial trends financial impact and process improvements to senior leadership and cross-functional teams.
• Key Metrics Monitoring:
• Monitor key performance indicators (KPIs) related to denial management and provide insights into areas needing attention improvement or intervention.
• Ad Hoc Analysis:
• Perform ad hoc data analyses and reporting based on requests from leadership or other departments to support ongoing denial management and financial initiatives.

MINIMUM QUALIFICATIONS:

• Education: Bachelors degree in Business Healthcare Administration Data Analytics or a related field is required.
• Experience: Minimum of 3 years of experience in healthcare data analysis billing or revenue cycle operations with a focus on denial management.
• Proficiency in data analysis tools and software (e.g. Excel SQL Tableau) as well as Epic Cogito. Strong analytical organizational and problem-solving skills.
• Familiarity with healthcare billing systems coding standards (CPT ICD-10 HCPCS) and denial management processes.
• Licensure / Certification: Epic Reporting Certifications and/or Certified Revenue Cycle Executive (CRCE) or similar certification is required.
• This position is 100% remote offering flexibility in work location.
• The role requires occasional travel for training and meetings.

Additional Details

Emory is an equal opportunity employer and qualified applicants will receive consideration for employment without regard to race color religion sex national origin disability protected veteran status or other characteristics protected by state or federal law.

Emory Healthcare is committed to providing reasonable accommodations to qualified individuals with disabilities upon request. Please contact Emory Healthcares Human Resources at . Please note that one weeks advance notice is preferred.

Required Experience:

IC