Senior Denials Prevention Process Improvement Advisor
About The Position
The Senior Denials Prevention Process Improvement Advisor serves as a subject matter expert and strategic partner in reducing clinical and technical denials across the revenue cycle. The role drives root cause analysis and implements sustainable process enhancements, with a focus on identifying denial trends, collaborating with operational leaders and payer relations teams, and designing preventive strategies to improve first-pass yield and reduce rework. The advisor conducts data-driven assessments of denial drivers, develops and deploys best practices, facilitates cross-functional workshops, and monitors implemented solutions using key performance indicators such as denial rate reduction and appeal avoidance. The role also partners with IT and compliance teams to optimize workflows and ensure adherence to regulatory and contractual requirements. This is a remote position, with required ability and willingness to travel to and work onsite at client, temporary, or corporate office locations as business needs require. The position is limited to individuals who reside and are authorized to work in the United States. Compensation is $68,500–$103,000 based on experience.
Requirements
- Associate degree.
- 2 to 5 years of relevant experience.
- Advanced analytical skills.
- Deep knowledge of payer policies and revenue cycle operations.
- Ability to influence stakeholders.
- Inquisitiveness and openness to innovation, including AI, to explore better processes and reduce friction.
- Willingness and ability to travel to and work onsite at client, temporary, or corporate office locations as business needs require.
- Must reside and be authorized to work within the United States.
Nice To Haves
- Experience in healthcare or technology operations.
Responsibilities
- Conduct data-driven assessments of denial drivers and identify denial trends.
- Develop and deploy best practices and preventive strategies to reduce clinical and technical denials.
- Collaborate with operational leaders and payer relations teams to improve first-pass yield and reduce rework.
- Facilitate cross-functional workshops.
- Monitor the effectiveness of implemented solutions using KPIs, including denial rate reduction and appeal avoidance.
- Partner with IT and compliance teams to optimize workflows and ensure adherence to regulatory and contractual requirements.
- Influence stakeholders to achieve measurable improvements in financial performance and client satisfaction.
Benefits
- Bonus incentives
- Paid certifications
- Tuition reimbursement
- Comprehensive benefits, including healthcare, time off, retirement, and well-being programs
- Career advancement
- Professional development
- Quarterly and annual incentive programs
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What This Job Offers
Job Type
Full-time
Career Level
Senior
Education Level
Associate degree
