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Senior Associate – Restructuring and Turnaround Services, Healthcare and Life Sciences
RiveronAnalyzing healthcare revenue cycles for diverse clients with expertise in reimbursement and denial management. Leading analytical workstreams with a focus on performance and compliance.
ATS Keywords
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Hard Skills
reimbursement analysisdenial managementunderpayment identificationpayer contract evaluationfinancial modelingroot cause analysisdata analyticsrate modelingreimbursement adequacy assessmentdenial categorization
Soft Skills
communicationcollaborationanalytical accuracypresentation skillsproblem-solving
Tools & Technologies
Microsoft ExcelPower BITableauSQLEHR systemsEPICCernerAthenahealth
Industry Keywords
MedicareMedicaidCPTICD-10HCPCSrevenue code conventionsfee schedulespayment structures
Tech Stack
Tools & technologiesSQLTableau
About the role
Key responsibilities & impact- Lead analytical workstreams across RCM engagements with focus on reimbursement performance and denial management.
- Conduct comprehensive denial analyses to identify root causes and quantify revenue at risk.
- Perform underpayment audits by modeling expected reimbursement against payer contract terms and adjudicated payments.
- Analyze payer contracts to assess reimbursement adequacy and support negotiation initiatives.
- Build and maintain dynamic reimbursement models, denial trending dashboards, and KPI scorecards.
- Evaluate remittance data, EOBs, and payer adjudication patterns to detect underpayment trends.
- Research Medicare and Medicaid reimbursement updates to inform advisory recommendations.
- Prepare structured analytical exhibits and client-facing deliverables including reports and presentations.
- Collaborate with the Managing Director and cross-functional teams to ensure analytical accuracy and deliver quality outcomes.
Requirements
What you’ll need- Bachelor’s degree in Finance, Accounting, Health Administration, Health Information Management, or a related field; a Master’s degree is a plus.
- Minimum of 3 years of hands-on experience in provider and/or payer analytics.
- Strong track record in reimbursement analysis, denial management, underpayment identification, and payer contract evaluation.
- Extensive knowledge of commercial, Medicare, and Medicaid reimbursement methodologies, fee schedules, and payment structures.
- Deep expertise in denial management including denial categorization, root cause analysis, trending, and appeals.
- Proficient in payer contract analysis, including rate modeling and reimbursement adequacy assessment.
- Highly proficient in Microsoft Excel for complex financial modeling.
- Experienced with data analytics tools such as Power BI, Tableau, SQL, or comparable platforms.
- Working knowledge of at least one major EHR or practice management system (e.g., EPIC, Cerner, Athenahealth).
- Familiarity with CPT, ICD-10, HCPCS, and revenue code conventions.
- Ability to communicate complex findings clearly and confidently in both written and verbal forms.
- Experience working across both provider and payer environments.
Benefits
Comp & perks- medical, dental, and vision insurance
- 401(k) with company match
- PTO
- flexible work arrangements
- professional development opportunities