Denial Optimization Consultant

Job Summary

A company is looking for a Denial Optimization Consultant to enhance revenue cycle performance through data analysis and strategic initiatives.

Key Responsibilities:

• Analyze denial trends and root causes to develop targeted mitigation strategies
• Collaborate with payers to resolve systemic issues and improve adjudication outcomes
• Lead cross-functional initiatives to streamline revenue cycle processes

Required Qualifications:

• Bachelor's degree and 5-7 years of experience in healthcare optimization, revenue cycle management, or healthcare consulting
• Strong understanding of healthcare claim adjudication and reimbursement processes
• Proven ability to analyze complex data sets and identify actionable trends
• Experience influencing without authority to achieve improvements in denial prevention
• Proficiency in relevant software tools (e.g., Excel, Tableau, Power Bi, Epic, Cerner)