Revenue Cycle Denials Analyst

$60,050 - $79,560/Yr

Emory Healthcare - Atlanta, GA

Full-time - Mid Level

Remote - Atlanta, GA

1,001-5,000 employees

Ambulatory Health Care Services

About the position

The System Denials Analyst at Emory Healthcare is responsible for analyzing and reporting data related to hospital and professional billing denials. This role aims to provide insights into denial trends, support process improvements, and optimize the organization's revenue cycle performance. The analyst will work closely with various departments to ensure data accuracy and compliance while preparing reports to assist leadership in making informed decisions.

Responsibilities

• Gather and compile denial data from multiple systems for both hospital and professional billing.
• Ensure data accuracy and completeness before generating reports.
• Analyze denial patterns to identify root causes and collaborate with cross-functional teams to implement strategies that prevent future denials.
• Support the denial management team by providing data insights that inform process improvement initiatives aimed at reducing denial rates.
• Ensure all denial management activities comply with federal, state, and payer-specific regulations.
• Work closely with departments such as Billing, Coding, and Case Management to streamline processes and improve communication.
• Develop and maintain denial dashboards, ensuring that reporting tools are accurate, up-to-date, and aligned with organizational needs.
• Ensure data integrity in all reporting efforts, reconciling discrepancies and resolving data quality issues as needed.
• Prepare and deliver reports and presentations on denial trends, financial impact, and process improvements to senior leadership and cross-functional teams.
• Monitor key performance indicators (KPIs) related to denial management and provide insights into areas needing attention, improvement, or intervention.
• Perform ad hoc data analyses and reporting based on requests from leadership or other departments to support ongoing denial management and financial initiatives.

Requirements

• 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.

Nice-to-haves

• Experience with healthcare data visualization tools.
• Knowledge of regulatory compliance in healthcare billing.

Benefits

• Comprehensive health benefits that start day 1
• Student Loan Repayment Assistance & Reimbursement Programs
• Family-focused benefits
• Wellness incentives
• Ongoing mentorship, development, and leadership programs