[Hiring] Senior Denials Prevention Analyst @Stanford Health Care

Role Description

The Senior Denials Prevention Analyst is an operational subject‑matter expert in denial prevention who combines advanced revenue cycle analytics with targeted account sampling to identify trends, pinpoint root causes, and drive sustainable reductions in initial denials for maximum reimbursement.

• Prepares denial prevention materials that synthesize denial metrics, initiative status, and workgroup findings.
• Leads cross‑functional discussions to connect interdependent topics.
• Supports DPTF Workgroups by documenting minutes, key takeaways, action items, owners, and due dates, and coordinating follow‑ups.
• Monitors denial prevention KPIs and initiative progress.
• Quantifies net revenue opportunities and realized benefits.
• Maintains benefit‑tracking dashboards and concise leadership readouts.
• Partners closely with revenue cycle, clinical operations, and IT/Epic teams to translate insights into actionable prevention plans.
• Monitors and helps implement workflow and system improvements.
• Tracks adoption, outcomes, and barriers.
• Leverages strong problem‑solving, data visualization, and knowledge of reimbursement policies and healthcare operations to deliver durable results.

Qualifications

• High school diploma (or GED equivalent). Required
• Bachelor’s degree in a work-related field/discipline from an accredited college or university. Preferred
• 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.

Requirements

• 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 the ability to translate data into actionable insights.
• Ability to analyze and develop solutions to complex problems, including independently identifying problems through data analysis.
• Ability to analyze information, reach valid conclusions and make sound recommendations.
• Ability to manage, organize, prioritize, multi-task and adapt to changing priorities.
• Working knowledge of medical terminology, CPT-4, ICD-9/ICD-10, HCPCS, and modifiers, and how these items drive reimbursement.
• Analytical and problem-solving skills, with good judgment, attention to detail, and thorough follow-through.
• Excellent verbal and written communication skills; ability to present complex data clearly to stakeholders.
• Ability to communicate effectively in written and verbal formats including summarizing data, presenting results to senior leadership.
• Ability to establish and maintain effective working relationships.
• Knowledge of Microsoft Office software, including strong knowledge of Excel including but not limited to proficient with functions such as VLOOKUP, IF, IS, and macro commands for automation.
• Advanced reporting capabilities such as tableau, Power BI, SQL, etc. preferred.

Licenses and Certifications

• CPC - Certified Professional Coder required.
• CRCR - Certified Revenue Cycle Representative required.

Benefits

• SHC Commitment to Providing an Exceptional Patient & Family Experience.
• Equal Opportunity Employer: Stanford Health Care (SHC) strongly values diversity and is committed to equal opportunity and non-discrimination in all of its policies and practices.
• Base Pay Scale: Generally starting at $57.53 - $76.22 per hour.