Senior Denials Prevention Analyst

Stanford Health Care

. Perform revenue cycle denial analytics to trend issues, identify root causes, and prioritize denial prevention opportunities.

Posted 9/29/2026full-timeRemote • United StatesSenior💰 $58 - $76 per hourWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in revenue cycle denial analytics, including root cause analysis and denial prevention strategies. Proficient in utilizing data analysis to drive actionable insights and monitor key performance indicators within a healthcare setting.

Highest-signal resume keywords

Denial PreventionStatistical AnalysisEpic ReportingCPC - Certified Professional CoderMicrosoft Excel

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Revenue Cycle ManagementRoot Cause AnalysisData AnalysisDenial ManagementPrior AuthorizationCodingPayment ComplianceMedical TerminologyStatistical AnalysisKPI Monitoring

Soft Skills

Communication SkillsProblem-Solving SkillsOrganizational SkillsAttention to DetailRelationship Management

Tools & Technologies

EpicTableauPower BISQLMicrosoft Office

Certifications & Qualifications

CPC - Certified Professional CoderCRCR - Certified Revenue Cycle Representative

Industry Keywords

HealthcarePayer RequirementsReimbursement RulesCPT-4ICD-9ICD-10HCPCSDenial Prevention StrategiesRevenue IntegrityProfessional Billing

Tech Stack

Tools & technologies

SQLTableau

About the role

Key responsibilities & impact

Perform revenue cycle denial analytics to trend issues, identify root causes, and prioritize denial prevention opportunities.
Conduct targeted account sampling and case reviews to validate findings and help define corrective actions.
Prepare analytics summaries, denial prevention PowerPoints and reports, and leadership readouts.
Lead and facilitate cross-functional discussions and connect interdependent topics across workgroups.
Build and maintain action plans with owners, timelines, and success metrics; document minutes, takeaways, next steps, and follow-up communications.
Monitor denial prevention KPIs, initiative progress, and revenue impact; explain fluctuations and escalate barriers.
Lead root cause analysis with Patient Access, Patient Financial Clearance, UM/CM, CDI, HIM/Coding, Clinical Operations, and PFS.
Help develop and implement denial prevention strategies, workflows, and playbooks; monitor effectiveness through KPI reporting.
Monitor payer policy changes, national guidelines, and CMS/Medicare/Medicaid updates.
Maintain denial dashboards, action plans, and performance reports for leadership review.
Prepare denial reports and summary findings; document analyses and outcomes and escalate systemic risks and barriers.

Requirements

What you’ll need

High school diploma (or GED equivalent). Required
Five (5) years of progressively responsible and directly related work experience, with a preference for denial prevention, denial management, prior authorization, or revenue cycle specific experience.
Two (2) years’ experience in denial prevention, denial recovery, prior auth, registration, coding, or denial management related role within a healthcare setting.
1-2 years of statistical analysis experience.
Domain experience across 2+ of the following areas: PAS, PFC, HIMS, Revenue Integrity, Coding, Professional Billing and Follow-up, Hospital Billing and Follow-up, Denial Prevention, Denial Management/Recovery, or Payment Compliance.
Working knowledge of government and non-government payer requirements, reimbursement rules, laws, and regulations that govern billing/collection activities.
Working knowledge of Epic Hospital and/or Professional Billing; strong proficiency in Epic reporting, especially Slicer/Dicer, and ability to translate data into actionable insights.
Ability to analyze and develop solutions to complex problems, including independently identifying problems through data analysis.
Working knowledge of medical terminology, CPT-4, ICD-9/ICD-10, HCPCS, and modifiers.
Knowledge of Microsoft Office, including strong Excel knowledge with VLOOKUP, IF, IS, and macro commands for automation.
CPC - Certified Professional Coder required or CRCR - Certified Revenue Cycle Representative required.
Bachelor’s degree in a work-related field/discipline from an accredited college or university. Preferred.
Advanced reporting capabilities such as Tableau, Power BI, SQL, etc. preferred.
Excellent verbal and written communication skills; ability to present complex data clearly to stakeholders.
Ability to manage, organize, prioritize, multi-task, and adapt to changing priorities.
Analytical and problem-solving skills, good judgment, attention to detail, and thorough follow-through.
Ability to establish and maintain effective working relationships.