Denial Prevention Analyst

Here at Savista, we enable our clients to navigate the biggest challenges in healthcare: quality clinical care with positive patient experiences and optimal financial results. We partner with healthcare organizations to problem solve and deliver revenue cycle improvement services that enable their success, support their patients, and nurture their communities, all while living our values of Commitment, Authenticity, Respect and Excellence (CARE).

Essential Duties & Responsibilities

• Denials Subject Matter Expert: Act as the primary point of contact for denial-related questions, serving as the liaison between the client and internal revenue cycle teams to research issues and provide recommendations. As the role evolves, may provide similar support across multiple client accounts.
• Client Engagement: Participate in multiple monthly calls with the client to review denial trends, present findings, and answer questions. Build credibility and maintain professionalism in all interactions while navigating dynamic conversations.
• Trend Analysis: Analyze denial patterns to identify root causes and recommend proactive measures to prevent future denials.
• Data Collection & Reporting: Collect, compile, and analyze data from various sources to generate clear, accurate reports on denial rates, reasons, and impacts. Present monthly reports and insights to client stakeholders, highlighting key findings and actionable recommendations.
• Stakeholder Collaboration: Partner with hospital leadership to understand needs, address concerns, and provide tailored solutions to minimize denials.
• Process Improvement: Recommend and support process changes to enhance efficiency and reduce the likelihood of denials.
• Training and Education: Provide recommendations and supporting documentation to client staff on best practices for denial prevention and management when appropriate.
• Compliance: Ensure compliance with all relevant regulations, guidelines, medical policies and standards related to claims and denials.
• Documentation: Maintain accurate and up-to-date documentation of denial cases, interventions, and outcomes.
• Performance Metrics: Track and report on key performance indicators (KPIs) related to denial prevention efforts.

Qualifications & Competencies

• Bachelor’s degree in healthcare administration, business administration, finance, or a related field.
• 3+ years of experience in denial management, revenue cycle analysis, or a related healthcare role.
• Strong client-facing skills, with the ability to navigate complex conversations and present findings with professionalism and confidence.
• Excellent communication and presentation abilities, with experience presenting to leadership or external stakeholders.
• Strong analytical and problem-solving skills.
• Proficiency in data analysis tools and software.
• Knowledge of healthcare billing, coding, and reimbursement processes.
• High level of attention to detail and accuracy.
• Ability to work independently and collaboratively within a team.
• Certification in healthcare compliance, coding, or revenue cycle management is a plus.

Savista is required by state specific laws to include the salary range for this role when hiring a resident in applicable locations. The salary range for this role is from $55,000.00 to $59,000.00. However, specific compensation for the role will vary within the above range based on many factors including but not limited to geographic location, candidate experience, applicable certifications, and skills. Eligibility to participate in a discretionary annual incentive program is subject to the rules governing the program, whereby an award, if any, depends on various factors including, without limitation, individual and organizational performance.

SAVISTA is an Equal Opportunity Employer and does not discriminate against any employee or applicant for employment because of race, color, age, veteran status, disability, national origin, sex, sexual orientation, religion, gender identity or any other federal, state or local protected class.

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Originally posted on Himalayas