Note: The job is a remote job and is open to candidates in USA. R1 RCM is the leading provider of technology-driven solutions that enhance patient experiences and financial performance for healthcare organizations. The Performance Management Denials Analyst Standardization Lead will analyze denied claims to identify root causes and collaborate with operational teams to address issues impacting revenue cycle performance.

Responsibilities

• Help reduce preventable claim denials by identifying clinical, coding, and process‑driven root causes that negatively impact reimbursement and overall revenue cycle performance
• Analyze denied claims to develop and write clear problem statements that define the intended objective, where the process failed, and the specific failure points driving denials that outline where to fix the problem
• Partner closely with operational teams to validate medical terminology, coding accuracy, and front-end revenue cycle processes contributing to denials
• Assess and communicate the financial impact of denials, supporting initiatives aimed at reducing significant revenue loss and improving the bottom line for internal and external clients

Skills

• 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. Example: Spread sheet of 20,000 accounts need to be sorted down to specific data set of inventory wide data sliced to a narrow focus
• 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
• Medical terminology in denials
• The ability to write up charting assessment

Benefits

• This job is eligible to participate in our annual bonus plan at a target of 5.00%
• Competitive benefits package.

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