The Senior Denials Prevention Analyst is an operational subject-matter expert focused on denial prevention. This role combines revenue cycle analytics, targeted account sampling, and root-cause analysis to identify trends, reduce initial denials, and improve reimbursement.
The analyst prepares denial prevention materials, leads cross-functional discussions, supports workgroups by documenting outcomes and action items, and maintains dashboards that track initiative progress, revenue impact, and leadership reporting.
The position partners with revenue cycle, clinical operations, IT/Epic teams, and other stakeholders to translate insights into actionable prevention plans and monitor workflow, system, and policy improvements.
Education
- High school diploma or GED required
- Bachelor’s degree in a work-related field preferred
Experience
- 5 years of progressively responsible and directly related work experience preferred
- 2 years of experience in denial prevention, denial recovery, prior authorization, registration, coding, or denial management in a healthcare setting
- 1 to 2 years of statistical analysis experience
Knowledge and Skills
- Experience across two or more of: PAS, PFC, HIM/HIMS, revenue integrity, coding, professional billing and follow-up, hospital billing and follow-up, denial prevention, denial management/recovery, or payment compliance
- Knowledge of government and non-government payer requirements, reimbursement rules, and billing/collection regulations
- Working knowledge of Epic Hospital and/or Professional Billing, including Epic reporting tools such as Slicer/Dicer
- Understanding of medical terminology, CPT-4, ICD-9/ICD-10, HCPCS, and modifiers
- Strong analytical, problem-solving, and communication skills
- Proficiency with Microsoft Excel, including VLOOKUP, IF, IS, and macro commands
- Advanced reporting skills with Tableau, Power BI, or SQL preferred
Licensure / Certification
- CPC certification required, or
- CRCR certification required
Location
Sacramento, California, US
Employment Type
Full-time
Experience Level
Senior
Remote work allowed
Yes
Posted
1 month ago