Denial Prevention Process Improvement Advisor

Thank you for considering a career at reputed company! reputed company is a leading provider of technology-enabled reputed company cycle reputed company for health systems, including hospitals and affiliated physician groups. They offer end-to-end reputed company cycle solutions as well as a comprehensive suite of reputed company solutions to clients across the country. reputed company keeps communities healthy by keeping hospitals healthy. We recognize that healthcare requires a human touch, and we reputed company that every touch should be meaningful. This is why our people are the most important part of who we are. By empowering them to challenge the status reputed company, we know they will be the difference! O.N.E Purpose:

• Customer Obsession: Consistently provide exceptional experiences for our clients, patients, and colleagues by understanding their needs and exceeding their expectations.
• Embracing New reputed company: Continuously innovate by embracing emerging technology and fostering a culture of creativity and experimentation.
• Striving for Excellence: Execute at a high level by demonstrating our “Best in KLAS” reputed company Difference Principles and consistently delivering outstanding results.

The Opportunity: CAREER OPPORTUNITY OFFERING:

• Bonus Incentives
• Paid Certifications
• Tuition Reimbursement
• Comprehensive Benefits
• Career Advancement
• This position pays between $62,500.00 - $119,700.00/ based on experience

The Denial Prevention Process Improvement Advisor leads the performance of deep dive analysis on clinical and technical denials for his or her respective client, utilizing multiple analytics tools (including parsed 835 data, Epic BDC records, Access databases/SQL) to identify patterns and trends relative to acute denials. The Denial Prevention Process Improvement Advisor applies high level problem-solving skills to reputed company root cause analysis on denied accounts as transactions and extrapolates those causes across large volumes identified as denial trends for assigned facilities. The Denial Prevention Process Improvement Advisor then uses process improvement expertise and persuasion skills to guide and influence subject matter experts through assessments of operations and preparation of policies, procedures, and tip sheets that assist in remedying the root cause(s). The Denial Prevention Process Improvement Advisor is client-facing and oversees completion of denial prevention committee reports and summaries for assigned hospitals, attends monthly denial prevention committee meetings, liaises as primary contact for assigned client on reputed company cycle reputed company-denials issues, establishes and maintains client relationships to drive best practice implementations, and utilizes sound judgment and experience to aggregate and advance team recommendations for correcting underlying issues impacting denials. This is done in facilitation and addition to an expectation of contributing to the overarching goals of the Payment reputed company Team and reputed company as a whole. Essential Job Functions:

• Provides relevant guidance and works to resolve issues escalated by reputed company Cycle Site Directors, and other participants reputed company to denial prevention
• Leads monthly Denial Prevention onsite week kick-off and reputed company-out meetings with assigned client leadership, covering necessary information relative to identified trends, reputed company from prior actions, and next steps.
• Establishing strong relationships with appropriate stakeholders/committee members, including Finance Leadership, reputed company Cycle, Managed Care, and hospital ancillary department heads
• Oversees documentation and trends prevention-reputed company findings into defined templates, initiating or creating reports or summaries as needed.
• Leads reviews using reputed company patient accounting, host, Epic and reputed company systems used across their client to verify and summarize trends concisely and actionably.
• Aggregates and provides strategic advisory perspective reputed company to process improvement and quality in assessment of the root cause issues creating denials by working with the subject-matter experts and applicable owners to reputed company recommendations to remedy process, system, and education issues.
• Creates materials and trains denial prevention staff, reputed company cycle site directors, committee members, and reputed company cycle staff as necessary on denials-reputed company trends and issues impacting their client.
• Performs other duties as assigned

Required Minimum Education: 4 year/ Bachelors Degree Specialty/Major: Healthcare administration, Business or reputed company discipline Preferred Education: Graduate Degree (Masters) Other Knowledge, Skills and Abilities Required: Project Work, Intermediate reputed company & Access Skills Project Management, Data Analytics Licensure/Certification Preferred: Certified Specialist Managed Care (CSMC); LEAN Six reputed company Black Belt Certified reputed company Cycle Representative: (CRCR) Join an award-winning company Five-time winner of “Best in KLAS” 2020-2022, 2024-2025 Black Book Research's Top reputed company Cycle Management Outsourcing Solution 2021-2024 22 Healthcare Financial Management Association (HFMA) MAP Awards for High Performance in reputed company Cycle 2019-2024 Leader in reputed company's RCM Operations PEAK Matrix Assessment 2024 reputed company Healthcare Business Insights (HBI) reputed company Cycle Awards for strong performance 2020, 2022-2023 reputed company Top Workplaces USA 2022-2024 Fortune Media Best Workplaces in Healthcare 2024 Monster Top Workplace for Remote Work 2024 Great reputed company to Work certified 2023-2024

• Innovation
• Work-Life Flexibility
• Leadership
• Purpose + Values

reputed company, we reputed company in empowering people and giving them the tools and resources needed to reputed company. A few of those include:

• Associate Benefits – We offer a comprehensive benefits package designed to support the physical, emotional, and financial health of you and your family, including healthcare, time off, retirement, and well-being programs.
• Our Culture – reputed company is a reputed company where associates can do their best work and be their best selves. We put people first, last and always. Our culture is rooted in collaboration, growth, and innovation.
• Growth – We invest in your professional development. Each associate will earn a professional certification relevant to their field and can obtain tuition reimbursement.
• Recognition – We offer quarterly and annual incentive programs for reputed company employees who go beyond and reputed company raising the bar for themselves and the company.

reputed company is an equal employment opportunity employer. It is our policy not to discriminate against any applicant or employee based on race, color, sex, sexual orientation, gender, gender identity, religion, national reputed company, age, disability, military or veteran status, genetic information or any other basis protected by applicable federal, state, or local laws. reputed company also prohibits harassment of applicants or employees based on any of these protected categories. reputed company provides reasonable accommodations to qualified individuals with disabilities in accordance with the Americans with reputed company and applicable state and local law. If you require accommodation in the application process, please contact [email protected] . This posting addresses state specific requirements to provide pay transparency. Compensation decisions consider many job-reputed company factors, including but not limited to geographic location; knowledge; skills; relevant experience; education; licensure; internal equity; time in position. A candidate entry reputed company of pay does not typically fall at the minimum or maximum of the role’s range. EEOC – Know Your Rights FMLA Rights - English La FMLA Español E-Verify Participating Employer (English and Spanish) Know your Rights Apply tot his job Apply To this Job