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Remote Denial Prevention Analyst Jobs (NOW HIRING)

Westerkamp Group

PB Denial Specialist - EPIC

TX · Remote

$19.25 - $24.50/hr

... Analyst. In this crucial role, you will lead a team of denial specialists, driving the resolution of denied claims, identifying root causes, and implementing strategies to prevent future denials.

Westerkamp Group

PB Denial Specialist - EPIC

LA · Remote

$19.25 - $24.50/hr

... Analyst. In this crucial role, you will lead a team of denial specialists, driving the resolution of denied claims, identifying root causes, and implementing strategies to prevent future denials.

Westerkamp Group

PB Denial Specialist - EPIC

KY · Remote

$19.25 - $24.50/hr

... Analyst. In this crucial role, you will lead a team of denial specialists, driving the resolution of denied claims, identifying root causes, and implementing strategies to prevent future denials.

Westerkamp Group

PB Denial Specialist - EPIC

TN · Remote

$19.25 - $24.50/hr

... Analyst. In this crucial role, you will lead a team of denial specialists, driving the resolution of denied claims, identifying root causes, and implementing strategies to prevent future denials.

Westerkamp Group

PB Denial Specialist - EPIC

GA · Remote

$19.25 - $24.50/hr

... Analyst. In this crucial role, you will lead a team of denial specialists, driving the resolution of denied claims, identifying root causes, and implementing strategies to prevent future denials.

Westerkamp Group

PB Denial Specialist - EPIC

AL · Remote

$19.25 - $24.50/hr

... Analyst. In this crucial role, you will lead a team of denial specialists, driving the resolution of denied claims, identifying root causes, and implementing strategies to prevent future denials.

Evergreen Health

Denial Management Specialist

Kirkland, WA · Remote

$28.83 - $46.14/hr

... Remote in Washington State only Posted wage ranges represent the entire range from minimum to ... Communicates with payer representatives, contributes to denial prevention efforts, and adapts to ...

EvergreenHealth

Denial Management Specialist

Kirkland, WA · Remote

$28.83 - $46.14/hr

... Remote in Washington State only Posted wage ranges represent the entire range from minimum to ... Communicates with payer representatives, contributes to denial prevention efforts, and adapts to ...

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Remote Denial Prevention Analyst information

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$33K

$80.8K

$105.5K

How much do remote denial prevention analyst jobs pay per year?

As of Jul 26, 2026, the average yearly pay for remote denial prevention analyst in the United States is $80,750.00, according to ZipRecruiter salary data. Most workers in this role earn between $73,000.00 and $91,000.00 per year, depending on experience, location, and employer.

What is the difference between Remote Denial Prevention Analyst vs Remote Claims Specialist?

AspectRemote Denial Prevention AnalystRemote Claims Specialist
Primary FocusPreventing claim denials through analysis and process improvementsProcessing and adjudicating insurance claims
Required CredentialsKnowledge of insurance policies, certifications like CPC or CPC-A beneficialSimilar credentials, often CPC or medical billing certifications
Work EnvironmentRemote, healthcare or insurance companiesRemote, insurance or healthcare organizations
Industry UsageInsurance, healthcare, medical billingInsurance, healthcare, medical billing

The Remote Denial Prevention Analyst focuses on analyzing claims to prevent denials, while the Remote Claims Specialist handles processing and resolving claims. Both roles require similar credentials and work environments, but their core responsibilities differ in focus and daily tasks.

More about Remote Denial Prevention Analyst jobs
What cities are hiring for Remote Denial Prevention Analyst jobs? Cities with the most Remote Denial Prevention Analyst job openings:
What are the most commonly searched types of Denial Prevention Analyst jobs? The most popular types of Denial Prevention Analyst jobs are:
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Remote Denial Prevention Analyst jobs near you
Infographic showing various Remote Denial Prevention Analyst job openings in the United States as of July 2026, with employment types broken down into 86% Full Time, 7% Part Time, and 7% Contract. Highlights an 100% Remote job distribution, with an average salary of $80,750 per year, or $38.8 per hour.
Sr. Clinical Denials Prevention Analyst (Remote)

Sr. Clinical Denials Prevention Analyst (Remote)

Stanford Health Care

Remote

Full-time

Posted 17 days ago

Job description

If you're ready to be part of our legacy of hope and innovation, we encourage you to take the first step and explore our current job openings. Your best is waiting to be discovered.
Day - 08 Hour (United States of America)
This is a Stanford Health Care job.
A Brief Overview
The Senior Clinical Denials Prevention Analyst serves as a clinical subject matter expert focused on reducing clinically related, documentation-related, and clinical operations-related denials through data and account analysis. The role partners across clinical, operational, revenue cycle, and payer-facing teams to identify patterns, assess root causes, and recommend improvements across the care-to-claim continuum, both before and after claim submission. The analyst proactively engages stakeholders to develop data-informed remediation strategies, support workflow optimization, and establish upstream practices that mitigate avoidable denials and accelerate resolution of those that cannot be prevented. Using a range of analytics and financial analysis, the position monitors performance, uncovers systemic issues, and translates insights into practical, sustainable solutions. Through continuous improvement initiatives and targeted education, this role strengthens revenue integrity and enhances overall denial and revenue performance.
Locations
Stanford Health Care
What you will do
  • Analyze denial and write-off data across payers to identify patterns, root causes, and prevention opportunities across clinical, documentation, coding, and charging processes for both pre-bill and post-bill denials.
  • Conduct denial reviews to identify gaps in documentation, UM or revenue cycle workflows, coding, and billing rules and collaborate with UM, CDI, coding, and case managers to address gaps and implement corrective actions.
  • Lead cross-functional root-cause analyses with UM, CDI, HIM, Coding, Case Management, Billing, and payer teams to design and implement remediation strategies.
  • Help develop and implement denial prevention strategies, workflows, and playbooks and monitor their effectiveness through regular KPI reporting.
  • Monitor payer policy changes, national guidelines, and CMS/Medicare/Medicaid updates to ensure compliance and timely adjustment of practices.
  • Maintain denial dashboards, action plans, and performance reports for leadership review.
  • Prepare summary findings of analysis for department leadership; maintain clear documentation of analyses and outcomes; escalate systemic risks and barriers as appropriate.
  • Provide root cause analysis and support the mitigation of denial and denial write-off trends.
  • Perform standard to moderately complex financial and operational analyses to quantify impact, inform decisions, and track benefits realization.

Education Qualifications
  • Bachelor's Degree (BSN) is highly preferred. Diploma or Associate's Degree in Nursing accepted when accompanied by strong demonstrated competencies and significant experience.

Experience Qualifications
  • Minimum of five (5) years in nursing with a minimum of two (2) years' experience as Utilization Management Nurse in an acute care setting required. UM or CM leadership experience preferred.
  • Experience and working knowledge of 2 Midnight, Milliman, and InterQual Guidelines required.
  • Minimum of two (2) years of experience in denial prevention, denial recovery, clinical appeals, or related denial-management responsibilities within a healthcare setting.
  • Experience with Epic HB and PB highly desirable

Required Knowledge, Skills and Abilities
  • Strong understanding of ICD-10-CM/PCS, CPT/HCPCS coding, and medical necessity guidelines.
  • Strong understanding of 2 Midnight, Milliman, and InterQual Guidelines
  • Familiarity with payer policies, reimbursement methodologies, and CMS guidelines (including Medicare/Medicaid rules) and common commercial payer practices.
  • Knowledge of CDI concepts, documentation standards, and revenue cycle processes.
  • Ability to apply high-level problem-solving skills to perform root cause analysis on denied accounts and develop actionable remediation strategies.
  • Ability to manage, organize, prioritize, multi-task and adapt to changing priorities.
  • Ability to communicate effectively in written and verbal formats including summarizing data, presenting results.
  • Ability to establish and maintain effective working relationships.
  • Working knowledge of hospital and physician revenue cycle systems, including Epic.

Licenses and Certifications
  • CA Registered Nurse - Valid license as a Registered Nurse issued by the California Board of Registered Nursing (BRN). Any combination of education and experience that would likely provide the required knowledge, skills and abilities as well as possession of any required licenses or certifications is qualifying. required Upon Hire
  • CRCR - Certified Revenue Cycle Representative preferred

These principles apply to ALL employees:
SHC Commitment to Providing an Exceptional Patient & Family Experience
Stanford Health Care sets a high standard for delivering value and an exceptional experience for our patients and families. Candidates for employment and existing employees must adopt and execute C-I-CARE standards for all of patients, families and towards each other. C-I-CARE is the foundation of Stanford's patient-experience and represents a framework for patient-centered interactions. Simply put, we do what it takes to enable and empower patients and families to focus on health, healing and recovery.
You will do this by executing against our three experience pillars, from the patient and family's perspective:
  • Know Me: Anticipate my needs and status to deliver effective care
  • Show Me the Way: Guide and prompt my actions to arrive at better outcomes and better health
  • Coordinate for Me: Own the complexity of my care through coordination

Equal Opportunity Employer Stanford Health Care (SHC) strongly values diversity and is committed to equal opportunity and non-discrimination in all of its policies and practices, including the area of employment. Accordingly, SHC does not discriminate against any person on the basis of race, color, sex, sexual orientation or gender identity and/or expression, religion, age, national or ethnic origin, political beliefs, marital status, medical condition, genetic information, veteran status, or disability, or the perception of any of the above. People of all genders, members of all racial and ethnic groups, people with disabilities, and veterans are encouraged to apply. Qualified applicants with criminal convictions will be considered after an individualized assessment of the conviction and the job requirements.
Base Pay Scale: Generally starting at $66.52 - $88.14 per hour
The salary of the finalist selected for this role will be set based on a variety of factors, including but not limited to, internal equity, experience, education, specialty and training. This pay scale is not a promise of a particular wage.

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