Data Management Analyst, Denials AI
About The Position
The Data Management Analyst, Denials AI is responsible for ensuring that cases for all activated DenialsAI accounts are successfully created and actively worked. The role performs daily data monitoring and reconciliation to identify gaps in case creation, case progression, user activity, and appeal output. The analyst investigates discrepancies throughout the DenialsAI data pipeline, develops and maintains operational reports and dashboards, communicates findings to internal and external stakeholders, and tracks resolution and account-health metrics. The role also validates reporting accuracy and handles protected health information in accordance with HIPAA and information security policies.
Requirements
- Bachelor’s degree in Data Analytics, Computer Science, Information Systems, Statistics, or a related field.
- At least 3 years of experience in data analysis.
- Strong SQL skills, including the ability to write complex queries across multiple data sources and large datasets.
- Experience building reports and dashboards for operational monitoring.
- Familiarity with data pipelines and ETL processes, including the ability to trace data flow across system layers.
- Proficiency in Microsoft Office Suite.
- Strong interpersonal skills and ability to communicate effectively at all levels of the organization.
- Strong problem-solving and creative skills, with sound judgment and the ability to make decisions based on accurate and timely analyses.
- High integrity and dependability, a strong sense of urgency, and a results-oriented approach.
- Excellent written and verbal communication skills.
- Must possess a smartphone or electronic device capable of downloading applications for multifactor authentication and security purposes.
- Must be able to follow directions, collaborate with others, and handle stress.
Nice To Haves
- Data analysis experience in healthcare technology or revenue cycle management.
- Experience with reporting and dashboard tools such as Tableau or Power BI.
- Knowledge of healthcare claims data and denial management workflows.
- Experience with AWS data services such as Athena, S3, and Glue.
Responsibilities
- Perform daily monitoring and reconciliation of activated DenialsAI accounts to verify the completeness and accuracy of case creation.
- Identify accounts where cases are not being created, progressing through workflow statuses, or generating expected appeal output.
- Investigate root causes of data discrepancies across the DenialsAI pipeline.
- Build and maintain reports and dashboards that track account health, case creation success rates, and operational activity metrics.
- Communicate identified gaps and supporting data to engineering, operations, client services, and external stakeholders, with 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.
- Perform other duties as assigned.
- Use, protect, and disclose patients’ protected health information only in accordance with HIPAA standards.
- Comply with information security and HIPAA policies and procedures, and limit viewing of PHI to the minimum necessary for assigned duties.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
