Director, Denials Prevention & Revenue Cycle Optimization

Beth Israel Lahey Health; Boston (MA); On-site; USD 165,000 - 180,000; Full time

Job summary

Beth Israel Lahey Health (BILH) seeks a Director, Denials Prevention & Performance Improvement to lead enterprise strategy for reducing denials and improving upstream workflows across Revenue Cycle. You will oversee analytics, governance, and cross-functional remediation efforts to strengthen financial outcomes.

The role partners with Clinical Revenue Cycle, physician advisors, and clinical departments to address documentation, medical necessity, and coding-related denial drivers while aligning

Qualifications

• Bachelor’s degree required; Master’s degree preferred.
• 5-8 years’ demonstrated experience leading Revenue Cycle performance improvement initiatives in a complex health system.
• Deep knowledge of hospital and professional billing workflows and denial prevention best practices.
• Strong analytical abilities with capacity to synthesize complex data into actionable strategies.
• Ability to influence physicians, clinical leaders, and operational stakeholders without direct authority.
• Executive presence and strong communication skills for presenting complex issues to senior leadership.
• Strong understanding of clinical, technical, and payer-related denial drivers and upstream workflow dependencies.

Responsibilities

• Lead the development and execution of an enterprise denials prevention strategy across hospital and professional billing environments.
• Analyze denial trends to identify root causes and drive upstream corrective actions.
• Partner with Clinical Revenue Cycle, Physician Advisors, and clinical departments to address documentation, medical necessity, and coding-related denial drivers.
• Collaborate with Access & Experience to mitigate front-end authorization and eligibility denials.
• Coordinate with Patient Financial Services to understand denial patterns, payer-specific issues, and system-level trends.
• Establish enterprise standards for denial categorization, tracking, reporting, and root cause identification.
• Lead structured performance improvement initiatives using disciplined problem-solving methodologies.
• Oversee Revenue Cycle digital and automation strategy to enhance work queues, workflows, and system configuration.
• Deploy technology-enabled solutions (automation, reporting enhancements, workflow redesign) to strengthen productivity and reduce manual effort.
• Monitor initiative ROI and ensure measurable improvements in denial rate, net revenue yield, and AR performance.
• Partner with Revenue Cycle Business Partners and PFS Denial Recovery lead to prioritize facility-specific interventions based on performance trends.
• Collaborate with Enabling Services (Reporting & Analytics) to enhance dashboards and KPI visibility for operational and clinical leaders.
• Maintain current knowledge of regulatory requirements, payer rules, industry trends, and emerging technologies to inform strategic planning.
• Elevate systemic risks and opportunities to Revenue Cycle and Executive Financial Leadership.

Skills

Denials prevention

Analytics

Influence without authority

Executive presence

Denial drivers

Education

Bachelor's degree

Master's degree

Tools

Epic Revenue Cycle

Job description

Beth Israel Lahey Health (BILH) seeks a Director, Denials Prevention & Performance Improvement to lead enterprise strategy for reducing denials and improving upstream workflows across Revenue Cycle. You will oversee analytics, governance, and cross-functional remediation efforts to strengthen financial outcomes.

The role partners with Clinical Revenue Cycle, physician advisors, and clinical departments to address documentation, medical necessity, and coding-related denial drivers while aligning