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, identifying denial trends and collaborating with operational leaders and payer relations teams to design preventive strategies that improve first-pass yield and reduce rework. The advisor conducts data-driven assessments, develops and deploys best practices, facilitates cross-functional workshops, and monitors implemented solutions using KPIs such as denial rate reduction and appeal avoidance. The position also partners with IT and compliance teams to optimize workflows and ensure adherence to regulatory and contractual requirements. It requires advanced analytical skills, deep knowledge of payer policies and revenue cycle operations, and the ability to influence stakeholders to improve financial performance and client satisfaction. This is a remote position, with required willingness and ability 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 within the United States.
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 to achieve measurable improvements.
- 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 preferred.
Responsibilities
- Conduct data-driven assessments of denial drivers.
- Develop and deploy best practices for denial prevention.
- Facilitate cross-functional workshops.
- Monitor implemented solutions through KPIs, including denial rate reduction and appeal avoidance.
- Collaborate with operational leaders and payer relations teams to develop preventive strategies.
- Partner with IT and compliance teams to optimize workflows and ensure adherence to regulatory and contractual requirements.
- Drive root cause analysis and implement sustainable process enhancements to reduce clinical and technical denials.
- Influence stakeholders to achieve measurable improvements in financial performance and client satisfaction.
Benefits
- Bonus incentives and quarterly and annual incentive programs.
- Paid professional certifications.
- Tuition reimbursement.
- Comprehensive benefits, including healthcare, time off, retirement, and well-being programs.
- Career advancement and professional development opportunities. Selections for all employees include a professional certification relevant to their field.
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What This Job Offers
Job Type
Full-time
Career Level
Senior
Education Level
Associate degree
