Data Management Analyst, Denials AI

Med-Metrix•Parsippany-Troy Hills, NJ

About The Position

The Data Management Analyst, Denials AI is responsible for ensuring all activated DenialsAI account cases are successfully created and actively being worked. The Data Management Analyst, Denials AI performs daily data monitoring and reconciliation to identify gaps in case creation, case progression, user activity, and appeal output.

Requirements

Bachelor’s degree in Data Analytics, Computer Science, Information Systems, Statistics, or related field required
3+ years of experience in data analysis, preferably in healthcare technology or revenue cycle management required
Strong SQL skills with the ability to write complex queries across multiple data sources and large datasets
Experience building reports and dashboards for operational monitoring (e.g., Tableau, Power BI, or similar)
Familiarity with data pipelines and ETL processes; ability to trace data flow across system layers
Proficiency in Microsoft Office Suite
Strong interpersonal skills, ability to communicate well at all levels of the organization
Strong problem solving and creative skills and the ability to exercise sound judgment and make decisions based on accurate and timely analyses
High level of integrity and dependability with a strong sense of urgency and results oriented
Excellent written and verbal communication skills required

Nice To Haves

Knowledge of healthcare claims data and denial management workflows preferred
Experience with AWS data services (Athena, S3, Glue) preferred

Responsibilities

Perform daily monitoring and reconciliation of all activated DenialsAI accounts to verify case creation completeness and accuracy
Identify accounts where cases are not being created, not progressing through workflow statuses, or not generating expected appeal output
Investigate root causes of data discrepancies across the DenialsAI pipeline
Build and maintain reports and dashboards tracking account health, case creation success rates, and operational activity metrics
Communicate identified gaps to engineering, operations, client services, and external stakeholders with supporting data and recommended categorization
Track gap resolution metrics including time-to-resolution, recurrence rates, and coverage percentages
Maintain a KPI scorecard measuring idle accounts, resolution SLA adherence, and active account coverage
Define and monitor thresholds for case creation failures and operational inactivity in collaboration with operations leadership
Validate data accuracy across reports provided to operations and client teams
Use, protect and disclose patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards
Understand and comply with Information Security and HIPAA policies and procedures at all times
Limit viewing of PHI to the absolute minimum as necessary to perform assigned duties
Other duties as assigned