Engage with revenue cycle and finance stakeholders to understand existing denial management processes, data flows, and key performance drivers.
Conduct detailed assessments of current denial root causes, resolution workflows, and reporting capabilities.
Map current-state workflows to the target product environment, identifying opportunities for automation and predictive analytics.
Design best-practice denial management processes leveraging product capabilities such as denial categorization, rules engines, workflow automation, and AI-driven insights.
Define key metrics, dashboards, and reports to track denial trends and root-cause performance.
Validate configuration of rules, workflows, and dashboards to ensure alignment with intended design and KPIs.
Advise clients and internal teams on how to leverage predictive models, dashboards, and trend analyses to improve performance.
Help clients visualize a data-driven approach to denial prevention and revenue protection.

7+ years in revenue cycle operations, analytics, or healthcare technology, with focus on denial management, claims, or performance analytics.
Experience configuring or implementing denial management or analytics tools (e.g., Epic Resolute, nThrive, FinThrive, Waystar, Change Healthcare, MedeAnalytics, or equivalent).
Familiarity with claims data standards (ANSI 837/835), payer denial codes, and root-cause analytics.
Proficiency in data visualization and analytics platforms (e.g., Tableau, Power BI, Looker).
Bachelor’s degree in Healthcare Administration, Informatics, Computer Science, Statistics, or related field (Master’s preferred).

Product SME – Denial Management, Data Analytics

Key skills