[Hiring] Senior Denials Prevention Process Improvement Advisor @Ensemble Health Partners

Role Description

The Senior Denials Prevention Process Improvement Advisor serves as a subject matter expert and strategic partner in reducing clinical and technical denials across the revenue cycle by driving root cause analysis and implementing sustainable process enhancements. This role focuses on identifying denial trends, collaborating with operational leaders and payer relations teams, and designing preventive strategies that improve first-pass yield and reduce rework.

• Conducting data-driven assessments of denial drivers.
• Developing and deploying best practices.
• Facilitating cross-functional workshops.
• Monitoring the effectiveness of implemented solutions through KPIs such as denial rate reduction and appeal avoidance.
• Partnering with IT and compliance teams to optimize workflows and ensure adherence to regulatory and contractual requirements.

Qualifications

• Associate degree; 2 to 5 years of relevant experience.
• Must be inquisitive and demonstrate openness to innovation including AI to explore better processes and ways to alleviate friction and improve patient and client experiences.
• This is a remote position; however, candidates must be willing and able to travel to and work onsite at client, temporary, or corporate office locations as business needs require.

Requirements

• Advanced analytical skills.
• Deep knowledge of payer policies and revenue cycle operations.
• Ability to influence stakeholders to achieve measurable improvements in financial performance and client satisfaction.

Benefits

• Bonus Incentives.
• Paid Certifications.
• Tuition Reimbursement.
• Comprehensive Benefits.
• Career Advancement.