Denials Management Associate

Overview

Join us as we work to create a thriving ecosystem that delivers accessible, high-quality, and sustainable healthcare for all.

Position Summary:

The Denials Management Associate will be responsible for the delivery and execution of business solutions within our operations division. Your mission will be to propose and implement solutions to improve customer value and athena operational efficiency. To succeed, you are a strong analytical problem solver and an excellent communicator. The Associate is a critical thinker who creates business cases, influences stakeholders, and demonstrates command of technical and industry knowledge.

The Associate will manage and influence project teams to action, balancing urgency while cultivating lasting collegial relationships.

Essential Functions (Duties and Responsibilities):

50% Business Analysis and Process Improvement

• Use data analysis and qualitative evaluation to determine root causes of a problem
• Analyze trends to deliver clear and compelling data stories to stakeholders
• Design elegant solutions that favor automation, work prevention, and product enhancement over manual workflows
• Seek and consume internal and external client feedback to inform decision making and improvement opportunities
• Identify opportunities to expand the value we provide to clients through more or better service(s) using your understanding of customer business problems
• Design and implement workflows to define and improve business processes

45% Project & Stakeholder Management

• Lead initiatives and projects that improve client and operational outcomes over a planning cycle, representing broad subject matter expertise
• Creates and curates project plans and initiative roadmap, balancing and setting clear stakeholder expectations and proactively identifying areas of risk
• Ensure success by leading execution across the company - including commercial, R&D, and operations
• Identify metrics and define success criteria to create transparency and visibility into program success and/or improvement areas
• Interface with internal and external stakeholders as needed to remediate pain points and optimize desired outcomes
• Discover customer requirements and improve the service by incorporating feedback into product and service prioritization
• Present project purpose, updates, and outcomes to Operations and stakeholder leadership, demonstrating command over all components of the project

5% Mentorship and Training

• Provide support, mentoring, and ongoing education opportunities for new hires and colleagues across Operations, creating content and collateral as needed
• Shares role specific content knowledge
• Actively participates with team and engages peers in learning and understanding

Education & Experience

Required:

• Bachelor’s Degree (or commensurate level of professional experience)
• 3-5 years of professional experience
• Experience working denials or within the revenue cycle
• Experience working with cross-functional groups and teams to achieve common goals and communicating and presenting to stakeholders
• Demonstrated ability to assume sole and independent responsibility for various projects
• Experience interfacing with internal or external customers to achieve a desired objective

Knowledge &

Skills:

• Proficiency in Microsoft Office Suite:
  Excel, PowerPoint, Word, Outlook, One Note
• Knowledge of Lean Six Sigma and Agile development methodologies preferred
• SQL experience preferred

Our vision: In an industry that becomes more complex by the day, we stand for simplicity. We offer IT solutions and expert services that eliminate the daily hurdles preventing healthcare providers from focusing entirely on their patients — powered by our vision to create a thriving ecosystem that delivers accessible, high-quality, and sustainable healthcare for all.

Our company culture: Our talented employees — or athenistas, as we call ourselves — spark the innovation and passion needed to accomplish our vision. We are a diverse group of dreamers and do-ers with unique knowledge, expertise, backgrounds, and perspectives. We unite as mission-driven problem-solvers with a deep desire to achieve our vision and make our time here count. Our…