Job Description
Overview Be inspired. Be rewarded. Belong. At Emory Healthcare. At Emory Healthcare we fuel your professional journey with better benefits, valuable resources, ongoing mentorship and leadership programs for all types of jobs, and a supportive environment that enables you to reach new heights in your career and be what you want to be. We provide:
- Comprehensive health benefits that start day 1
- Student Loan Repayment Assistance & Reimbursement Programs
- Ongoing mentorship, development, and leadership programs
Epic Certification required. Description RESPONSIBILITIES: - The System Denials Analyst, is responsible for gathering, analyzing, and reporting data related to both hospital and professional billing denials across the healthcare system.
- Reporting to the Director of Enterprise Denial Management, this role provides critical insights into denial trends and patterns by pulling data from various sources, identifying areas for process improvement, and supporting efforts to optimize the organization's revenue cycle performance.
- The position focuses on data accuracy, trend analysis, and preparing reports to assist leadership in making data-driven decisions to reduce denials and improve overall Data Collection and Reporting
- Gather and compile denial data from multiple systems for both hospital and professional billing.
- Ensure data accuracy and completeness before generating reports.
- Trend & Root Cause Analysis:
- Analyze denial patterns to identify root causes, collaborating with cross-functional teams to implement strategies that prevent future denials.
- Process Improvement Support:
- Support the denial management team by providing data insights that inform process improvement initiatives aimed at reducing denial rates.
- Regulatory Compliance:
- Ensure all denial management activities comply with federal, state, and payer-specific regulations.
- Cross Functional Collaboration:
- Work closely with departments such as Billing, Coding, and Case Management to streamline processes and improve communication.
- Reporting Tools:
- Develop and maintain denial dashboards, ensuring that reporting tools are accurate, up-to-date, and aligned with organizational needs.
- Data Integrity:
- Ensure data integrity in all reporting efforts, reconciling discrepancies and resolving data quality issues as needed.
- Stakeholder Communication:
- Prepare and deliver reports and presentations on denial trends, financial impact, and process improvements to senior leadership and cross-functional teams.
- Key Metrics Monitoring:
- Monitor key performance indicators (KPIs) related to denial management, and provide insights into areas needing attention, improvement, or intervention.
- Ad Hoc Analysis:
- Perform ad hoc data analyses and reporting based on requests from leadership or other departments to support ongoing denial management and financial initiatives.
MINIMUM QUALIFICATIONS: - Education: Bachelor's degree in Business, Healthcare Administration, Data Analytics, or a related field is required.
- Experience: Minimum of 3 years of experience in healthcare data analysis, billing, or revenue cycle operations, with a focus on denial management.
- Proficiency in data analysis tools and software (e.g., Excel, SQL, Tableau) as well as Epic Cogito. Strong analytical, organizational, and problem-solving skills.
- Familiarity with healthcare billing systems, coding standards (CPT, ICD-10, HCPCS), and denial management processes.
- Licensure / Certification: Epic Reporting Certifications and/or Certified Revenue Cycle Executive (CRCE) or similar certification is required.
- This position is 100% remote, offering flexibility in work location.
- The role requires occasional travel for training and meetings.
Additional Details Emory is an equal opportunity employer, and qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, protected veteran status or other characteristics protected by state or federal law.
Emory Healthcare is committed to providing reasonable accommodations to qualified individuals with disabilities upon request. Please contact Emory Healthcare's Human Resources at careers@emoryhealthcare.org. Please note that one week's advance notice is preferred.
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