Payer Denials Analytics Lead

Med--metrix; United States; Remote; USD 75,000 - 95,000; Full time

Job summary

Med-Metrix is seeking a Technical Denials Analyst to identify drivers of non-clinical denials across payers and to partner with billing, patient access and other Revenue Cycle teams to reduce recurrence.

The role requires analyzing denial patterns, leading cross-functional remediation efforts, and communicating findings to executive leadership while ensuring HIPAA compliance and data security.

Qualifications

• Bachelor's degree or equivalent in healthcare admin, business, finance, or related field.
• 4+ years in healthcare billing, claims, credentialing, EDI, or denial analysis.
• Advanced knowledge of payer requirements (commercial, Medicare, Medicaid).
• Ability to analyze denial data and identify patterns by payer/department/facility.
• Strong skills in communicating findings to leadership and stakeholders.
• Experience with denial rules and claim lifecycle (CARC/RARC, 837/835).

Responsibilities

• Serve as subject matter expert for technical denials across payers; identify recurring patterns.
• Lead cross-functional sessions to validate findings and define remediation steps.
• Monitor denial trends and escalate material changes or risks.
• Maintain recurring reporting on denial rates and outcomes.
• Document findings and follow up when results do not improve.
• Advise leadership on denial risks and payer changes.
• Work outside normal hours as needed.

Skills

Analytical thinking

Cross-functional collaboration

Communication skills

Independent judgment

Problem solving

Attention to detail

Education

Bachelor's degree in healthcare administration, business, finance, or related field

Tools

SQL

BI tools

Microsoft Office

Excel

Job description

Med-Metrix is seeking a Technical Denials Analyst to identify drivers of non-clinical denials across payers and to partner with billing, patient access and other Revenue Cycle teams to reduce recurrence.

The role requires analyzing denial patterns, leading cross-functional remediation efforts, and communicating findings to executive leadership while ensuring HIPAA compliance and data security.