Senior Business Analyst

The Senior Business Analyst – Denial Analytics is a key member of the Enterprise Denial Management team, with a focus on leveraging data to uncover denial trends, identify root causes, and provide actionable insights that inform enterprise-wide strategies. This individual will support the PRIZM platform—our core denial analytics engine—and collaborate with both clinical and operational stakeholders to drive measurable improvements in revenue recovery and denial prevention.
 

This role will report to the Senior Manager responsible for PRIZM oversight and serve as a subject matter expert in data visualization, claims analysis, and revenue cycle intelligence.

Key Responsibilities:
•    Analyze denial-related data from PRIZM and other systems to identify trends, patterns, and root causes impacting reimbursement.
•    Build dashboards, models, and reports that translate complex data into clear, actionable insights for executive leadership and operational teams.
•    Work collaboratively with denial operations teams, clinical departments, coding, and revenue cycle leadership to inform and align on data-driven initiatives.
•    Monitor key denial performance indicators (e.g., volume trends, appeal success rates, payer-specific denial rates) and escalate significant variances.
•    Serve as a PRIZM engine expert and support governance of data inputs, categorization logic, and model performance.
•    Translate business questions into analytical frameworks and communicate findings to both technical and non-technical audiences.
•    Provide support for strategic initiatives by contributing data analyses and recommendations during workgroup discussions or executive briefings.
•    Partner with IT and analytics teams to improve data quality, automation opportunities, and integration across platforms.
•    Document data definitions, logic, and workflows to support transparency and repeatability in reporting

Key Competencies:
•    Analytical Rigor & Attention to Detail
•    Business Acumen in Healthcare Revenue Cycle
•    Effective Communication & Data Storytelling
•    Cross-Functional Collaboration
•    Process Improvement & Root Cause Analysis
•    Stakeholder Engagement & Problem Solving