Revenue Cycle Data Analyst Revenue Integrity & Denials Mgmt Lawrenceville NJ

Capital Health is the region's leader in providing progressive, quality patient care with significant investments in our exceptional physicians, nurses and staff, as well as advanced technology. Capital Health is a dynamic health care resource accredited by the DNV that includes two hospitals, an outpatient center, satellite ED, and an expansive network of primary and specialty care. Capital Health Medical Group is made up of more than 600 physicians and other providers who offer primary and specialty care, as well as hospital-based services, to patients throughout the region.

Capital Health recognizes that attracting the best talent is key to our strategy and success as an organization. As a result, we aim for flexibility in structuring competitive compensation offers to ensure we can attract the best candidates.

$64,625.60 - $84,448.00

40

Responsible for delivering accurate, actionable reporting and insights across Revenue Cycle leadership, with a primary focus on Revenue Integrity and Denials Management. Supports operational and executive decision‑making by identifying trends, quantifying revenue risk/opportunity, and tracking performance across pre‑bill, claim adjudication, denial, and appeal workflows. Partners with clinical, billing, coding, case management, and finance teams to improve data visibility, reduce avoidable denials, and strengthen end‑to‑end revenue cycle performance.

• Education:
  
  Bachelor’s degree in healthcare administration, Finance, Business, Data Analytics, or related field.
• Experience:
  
  Three years’ experience in healthcare revenue cycle, revenue integrity, denials, reimbursement analytics, or related financial/operational analytics role.
• Other Credentials / Knowledge and
  
  Skills:
  
  Strong analytical skills with the ability to interpret complex healthcare claims and reimbursement data. Advanced proficiency in Excel (pivot tables, lookups, formulas, data validation). Experience creating reports and dashboards for leadership audiences. Strong communication skills with ability to translate data into clear business insights and recommendations.
• Special Training / Mental, Behavioral and Emotional Abilities:
  Must have ability to meet deadlines and attention to detail. Must demonstrate good judgment. Must be metric‑driven and results oriented.
• Usual Work Day: 8 Hours.
• Reporting Relationships:
  Does not formally supervise employees.

• Develop, maintain, and distribute recurring and ad hoc revenue cycle reports for leadership and operational teams.
• Build dashboards and scorecards focused on denial trends, appeal performance, underpayments, pre‑bill edits/holds, and revenue integrity outcomes.
• Analyze root causes of denials by payer, denial reason, service line, DRG, location, and workflow ownership.
• Monitor and report key KPIs, including (as applicable):
  Initial denial rate, Preventable denial rate, Appeal overturn rate, Days to appeal submission/resolution, DNFB aging and pre‑bill hold impact, Net collections and reimbursement variance trends.
• Support denials task force and revenue integrity governance by preparing meeting materials, trend summaries, and action‑oriented insights.
• Reconcile data across source systems (EMR, billing, clearinghouse, denials/work queue tools) and validate report accuracy.
• Monitor charge capture performance and identify potential revenue leakage across inpatient and outpatient workflows, including missed charges, late charges, charge lag, and documentation‑to‑bill discrepancies.
• Analyze trends in late charges and post‑bill adjustments; quantify financial impact and partner with clinical and operational leaders to strengthen charge capture controls and reduce avoidable revenue loss.
• Partner with leaders to define metric logic, data definitions, and reporting standards.
• Identify process breakdowns and collaborate with operations on corrective action tracking and follow‑up reporting.
• Assist with payer policy impact analyses and retrospective reviews to quantify financial and operational impact.
• Contribute to annual goal setting, baseline development, and performance monitoring across revenue…