Denials Standardization Lead Analyst

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🔥 23 minutes ago

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R1 RCM

10,000+ employees

Founded 2017

⚕️ Healthcare Insurance

☁️ SaaS

💸 Finance

💰 Private Equity Round on 2024-07

Healthcare Insurance • SaaS • Finance

R1 RCM is a leading provider of revenue cycle management solutions for the healthcare industry. With an emphasis on maximizing financial performance and optimizing patient care, R1 offers a comprehensive platform that integrates data analytics, intelligent technologies, and deep expertise in revenue cycle management. The company assists healthcare providers—ranging from hospitals and health systems to physician and specialty care practices—in capturing revenue opportunities, improving payer and patient cash flows, and ensuring compliance with government regulations. R1 is committed to driving cost reductions and revenue improvements while enhancing the patient experience. Their suite of services includes revenue recovery, clinical integrity, and regulatory navigation, making them a trusted partner for many top healthcare providers.

📋 Description

• Help reduce preventable claim denials by identifying clinical, coding, and process‑driven root causes • Analyze denied claims to develop and write clear problem statements • Partner closely with operational teams to validate medical terminology, coding accuracy, and processes contributing to denials • Assess and communicate the financial impact of denials

🎯 Requirements

• Minimum 2 years of experience in revenue cycle management with a focus on denials and performance management • Working knowledge of medical terminology related to denied claims • Experience collaborating with coding teams and stakeholders analyzing denial root causes • Need to have advance excel skills: pivot tables, data annualization, data visualizations • Complex Denial experience • Recent Revenue Cycle Front End Denial experience and understanding all revenue cycle front end processes • Experience identifying root causes and presenting cause and solution to management • The ability to write up charting assessment

🏖️ Benefits

• Competitive benefits package

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