Revenue Cycle Denials Analyst

$60,050 - $79,560/Yr

Emory Healthcare - Atlanta, GA

Full-time - Mid Level

Remote - Atlanta, GA

Ambulatory Health Care Services

About the position

The Revenue Cycle Denials Analyst at Emory Healthcare is responsible for analyzing and reporting data related to hospital and professional billing denials. This role involves gathering data from various sources, identifying trends and root causes of denials, and collaborating with cross-functional teams to implement process improvements. The analyst will support the organization's revenue cycle performance by ensuring data accuracy, compliance with regulations, and effective communication of insights to leadership.

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 teams to implement strategies that prevent future denials.
• Support the denial management team by providing data insights for process improvement initiatives.
• 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 reporting tools are accurate and up-to-date.
• Ensure data integrity in all reporting efforts, reconciling discrepancies and resolving data quality issues.
• 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.
• Perform ad hoc data analyses and reporting based on requests from leadership or other departments.

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