Senior Denials Prevention Process Improvement Advisor

This position is listed on behalf of a partner company, who manages all applications and next steps. Our partner is looking for a Senior Denials Prevention Process Improvement Advisor based in United States.

This role sits at the intersection of healthcare revenue cycle management, data analytics, and operational transformation within a high-impact healthcare services environment. You will lead deep-dive analyses of clinical and technical denials, uncovering root causes that affect hospital reimbursement performance and operational efficiency. Acting as a strategic advisor to hospital clients, you will translate complex datasets into clear, actionable insights that drive measurable improvements. The position requires strong client-facing communication, as you will regularly engage with hospital leadership and multidisciplinary stakeholders. You will also play a key role in shaping denial prevention strategies, influencing process redesign, and improving documentation and education practices. This is a highly analytical yet highly collaborative role with direct impact on healthcare financial health and patient service continuity.

• Lead comprehensive analysis of clinical and technical denials using advanced datasets, including 835 transactions, Epic records, and SQL-based tools to identify trends and root causes
• Conduct deep root cause analysis across denied claims and translate findings into scalable process improvement recommendations
• Partner with hospital leadership and revenue cycle teams to present findings, align on corrective actions, and support operational transformation initiatives
• Facilitate denial prevention committee meetings, including monthly reviews, kickoff sessions, and follow-ups on action plans and performance tracking
• Develop and maintain detailed reports, dashboards, and summaries documenting denial trends and remediation progress
• Act as a primary client-facing advisor for assigned hospital systems, ensuring strong stakeholder relationships and consistent communication
• Design and deliver training, documentation, and guidance materials to improve denial prevention practices across teams and departments
• Collaborate with subject matter experts to influence policy, workflow redesign, and system enhancements that reduce denial volume

Requirements

• Bachelor’s degree in Healthcare Administration, Business, Finance, or a related field
• 5+ years of experience in healthcare revenue cycle management, denial management, or healthcare analytics
• Strong experience performing data analysis using tools such as Excel, Access, SQL, and healthcare billing systems
• Proven ability to conduct root cause analysis and translate findings into operational improvements
• Experience working directly with hospital clients, providers, or healthcare system stakeholders in a consultative or advisory capacity
• Strong communication, presentation, and stakeholder management skills
• Ability to lead cross-functional discussions and influence operational and clinical teams
• Experience in process improvement, project management, or Lean/Six Sigma methodologies (certification preferred)
• Familiarity with Epic or other EHR systems is a strong plus
• Comfort working in a remote environment with periodic onsite client visits

Benefits

• Competitive salary ranging from approximately $69,000 to $104,100 depending on experience and location
• Annual bonus and incentive programs for high performance
• Comprehensive medical, dental, and vision insurance coverage
• Retirement savings plan (401k)
• Tuition reimbursement and paid certification programs
• Remote-first flexibility with occasional onsite client engagement
• Career advancement opportunities within a growing healthcare analytics organization
• Continuous learning and professional development support
• Recognition programs rewarding performance and impact