[ref. a73757824] Revenue 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

Work Location: Atlanta, GA (100% remote, candidates must live or have existing plans to relocate to the following states: Alabama, Arkansas, Florida, Georgia, Illinois, Louisiana, Michigan, New Hampshire, North Carolina, Ohio, Pennsylvania, South Carolina, Tennessee, Texas, Virginia and Wisconsin)

Description:

• 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 organization's 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:

• Bachelor's degree in Business, Healthcare Administration, Data Analytics, or a related field is preferred
• Alternatively, 5 years of experience in healthcare data analysis or revenue cycle management may be substituted for the educational requirement
• 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
• Epic Reporting Certifications and/or Certified Revenue Cycle Executive (CRCE) or similar certification is preferred
• This position is 100% remote, offering flexibility in work location
• The role requires occasional travel for training and meetings

The Emory Healthcare Network, established in 2011, is the largest clinically integrated network in Georgia, with more than 3,450 physicians concentrating in 70 different subspecialties.

Additional Details:

Emory Healthcare (EHC) is committed to achieving a diverse workforce through equal opportunity and nondiscrimination policy in all aspects of employment including recruitment, hiring, promotions, transfers, discipline, terminations, wage and salary administration, benefits, and training.

ACCOMMODATIONS: EHC will provide reasonable accommodation to qualified individuals with disabilities upon request. To request this document in an alternate format or to request a reasonable accommodation, please contact the Office of Diversity, Equity, and Inclusion.”

PHYSICAL REQUIREMENTS: (Medium-Heavy) 36-75 lbs., 0-33% of the work day (occasionally); 20-35 lbs., 34-66% of the workday; (frequently); 10-20 lbs., 67-100% of the workday (constantly); Lifting 75 lbs. max; Carrying of objects up to 35 lbs.; Occasional to frequent standing & walking; Occasional sitting; Close eye work (computers, typing, reading, writing); Physical demands may vary depending on assigned work area and work tasks.

ENVIRONMENTAL FACTORS: Factors affecting environmental conditions may vary depending on the assigned work area and tasks. Environmental exposures include, but are not limited to: Blood-borne pathogen exposure; Bio-hazardous waste Chemicals/gases/fumes/vapors; Communicable diseases; Electrical shock; Floor Surfaces; Hot/Cold Temperatures; Indoor/Outdoor conditions; Latex; Lighting; Patient care/handling injuries; Radiation; Shift work; Travel may be required; Use of personal protective equipment, including respirators; environmental conditions may vary depending on assigned work area and work tasks.