Note: The job is a remote job and is open to candidates in USA. R1 RCM provides technology-driven solutions that improve the patient experience and financial performance of hospitals, health systems, and medical groups. The Denials Standardization Lead Analyst analyzes denied claims, identifies clinical, coding, and process-related root causes, and partners with operational teams to reduce preventable denials and revenue loss.
Responsibilities
- Help reduce preventable claim denials by identifying clinical, coding, and process‑driven root causes that negatively impact reimbursement and overall revenue cycle performance
- Every day you'll 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
- Bachelors - Equivalent experience will be considered in lieu of a degree
- Minimum of 2 years experience
Benefits
- Eligible to participate in the annual bonus plan at a target of 5.00%
- Opportunity to constantly learn, collaborate across groups, and explore new paths for your career
Company Overview