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Remote Denial Prevention Analyst Jobs in Decatur, GA

ontrac

Loss Prevention Investigator

Atlanta, GA · On-site +1

$84K - $126K/yr

Location: Remote - This position may be performed remotely in states where the company is ... Collect and analyze evidence including transaction data, shipping records, surveillance footage ...

ontrac

Loss Prevention Investigator

Atlanta, GA · On-site +1

$84K - $126K/yr

Location: Remote - This position may be performed remotely in states where the company is ... Collect and analyze evidence including transaction data, shipping records, surveillance footage ...

ontrac

Loss Prevention Investigator

Atlanta, GA · On-site +1

$84K - $126K/yr

Location: Remote - This position may be performed remotely in states where the company is ... Collect and analyze evidence including transaction data, shipping records, surveillance footage ...

Deloitte

Hospital Billing Analyst

Atlanta, GA · Remote

$46.20K - $61.50K/yr

This is a primarily remote role supporting an enterprise Epic implementation, with minimal travel ... prevent avoidable denials, and submit supporting documentation required by payer guidelines

CGI Inc.

Remote Clinical Nurse Auditor

Atlanta, GA · On-site +1

Analytics and Emerging Digital Technologies Main location: United States, Georgia, Atlanta ... The review process may result in approval or denial of payment for previously-rendered services.

OmniMax International

Demand Forecast Analyst

GA · Remote

Wellness program with diabetes prevention, condition care, preventive care, and annual flu shot ... Remote We are proud of our commitment to equal employment opportunities for all qualified job ...

Omnimax

Demand Forecast Analyst

GA · On-site +1

Wellness program with diabetes prevention, condition care, preventive care, and annual flu shot ... Remote We are proud of our commitment to equal employment opportunities for all qualified job ...

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Remote Denial Prevention Analyst information

See Decatur, GA salary details

$32.2K

$78.8K

$103K

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

As of May 31, 2026, the average yearly pay for remote denial prevention analyst in Decatur, GA is $78,839.00, according to ZipRecruiter salary data. Most workers in this role earn between $71,300.00 and $88,800.00 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.

What are popular job titles related to Remote Denial Prevention Analyst jobs in Decatur, GA? For Remote Denial Prevention Analyst jobs in Decatur, GA, the most frequently searched job titles are:
What job categories do people searching Remote Denial Prevention Analyst jobs in Decatur, GA look for? The top searched job categories for Remote Denial Prevention Analyst jobs in Decatur, GA are:
What cities near Decatur, GA are hiring for Remote Denial Prevention Analyst jobs? Cities near Decatur, GA with the most Remote Denial Prevention Analyst job openings:
Remote Denial Prevention Analyst jobs near you
Restructuring and Turnaround Services, Healthcare and Life Sciences - Senior Associate (Revenue C...

Restructuring and Turnaround Services, Healthcare and Life Sciences - Senior Associate (Revenue C...

Riveron

Atlanta, GA • On-site, Remote

$90K - $145K/yr

Full-time

Medical, Dental, Vision, Retirement, PTO

Posted 18 hours ago

Job description

Restructuring and Turnaround Services, Healthcare and Life Sciences - Senior Associate (Revenue Cycle Management)
As an Analyst in our Healthcare and Life Sciences practice, you will serve as a subject matter resource on revenue cycle management, reimbursement analytics, denial management, and payer contract performance across a diverse client portfolio spanning healthcare providers and payers. You will leverage deep functional expertise to analyze complex financial and operational data, surface underpayment and denial trends, evaluate payer contract compliance, and deliver actionable recommendations that drive measurable improvements in net revenue and cash performance. This is a high-impact role for a seasoned-analytics professional ready to apply provider- and payer-side experience in a fast-paced advisory consulting environment.
Reporting to the Managing Director, Head of Revenue Cycle Management, you will own analytical workstreams, contribute directly to client-facing deliverables, and serve as a knowledgeable resource on reimbursement methodology, denial root cause analysis, and payer behavior across commercial, Medicare, and Medicaid lines of business.
Who You Are:
  • You hold a Bachelor's degree in Finance, Accounting, Health Administration, Health Information Management, or a related field; a Master's degree is a plus.
  • You have a minimum of 3 years of hands-on experience in provider and/or payer analytics, with a strong track record in reimbursement analysis, denial management, underpayment identification, and payer contract evaluation.
  • You possess extensive knowledge of commercial, Medicare, and Medicaid reimbursement methodologies, fee schedules, and payment structures, including DRG, APC, RBRVS, and value-based payment models.
  • You have deep expertise in denial management - including denial categorization, root cause analysis, trending, and appeals - with the ability to design denial prevention strategies and quantify financial impact.
  • You have demonstrated experience identifying and recovering underpayments through systematic contract modeling, remittance auditing, and payer comparison analysis.
  • You are proficient in payer contract analysis, including rate modeling, reimbursement adequacy assessment, and identification of contractual versus non-contractual variances.
  • You are highly proficient in Microsoft Excel for complex financial modeling, and experienced with data analytics tools such as Power BI, Tableau, SQL, or comparable platforms used in RCM analytics environments.
  • You have working knowledge of at least one major EHR or practice management system (e.g., EPIC, Cerner, Athenahealth) and clearinghouse/claims data environments.
  • You are familiar with CPT, ICD-10, HCPCS, and revenue code conventions as they relate to billing accuracy and reimbursement outcomes.
  • You communicate complex findings clearly and confidently, both in written deliverables and in verbal presentations to client stakeholders.
  • Experience working across both provider and payer environments, with the ability to interpret claims data and adjudication logic from multiple perspectives.
  • Familiarity with value-based care reimbursement models, shared savings arrangements, or risk-based contracting structures.
  • Experience with RCM technology platforms, clearinghouses, or denial management software (e.g., Waystar, Change Healthcare, Optum360).
  • Knowledge of HIPAA compliance, healthcare data privacy standards, and audit response protocols.
  • Prior experience in a consulting, advisory, or professional services environment.

What You'll Do:
  • Lead analytical workstreams across RCM engagements, with a primary focus on reimbursement performance, denial management, underpayment recovery, and payer contract compliance.
  • Conduct comprehensive denial analyses - including segmentation by denial reason, payer, service line, and provider - to identify systemic root causes and quantify revenue at risk.
  • Perform underpayment audits by modeling expected reimbursement against payer contract terms and adjudicated payments, flagging variances, and supporting recovery efforts.
  • Analyze payer contracts to assess reimbursement adequacy, identify rate discrepancies, and support contract negotiation or renegotiation initiatives.
  • Build and maintain dynamic reimbursement models, denial trending dashboards, and KPI scorecards that track performance against benchmarks and improvement targets.
  • Evaluate remittance data, EOBs, and payer adjudication patterns to detect underpayment trends, systematic errors, and payer behavior anomalies.
  • Research Medicare and Medicaid reimbursement updates, CMS policy changes, and commercial payer guideline revisions to assess client impact and inform advisory recommendations.
  • Prepare structured analytical exhibits, workpapers, and client-facing deliverables including reports, presentations, and financial summaries.
  • Collaborate with the Managing Director and cross-functional engagement teams to execute project workplans, ensure analytical accuracy, and deliver quality client outcomes.
  • Support business development activities including data-driven proposal development, market research, and benchmarking analysis.

Applications for this evergreen opportunity will be accepted through Dec 31, 2026.
About Riveron:
At Riveron, we partner with clients-from global multinationals to high-growth private entities-to solve complex finance challenges, guided by our DELTA values: Drive, Excellence, Leadership, Teamwork, and Accountability. Our entrepreneurial culture thrives on collaboration, diverse perspectives, and delivering exceptional outcomes. We are committed to fostering growth, both for our clients and our people, through mentorship, integrity, and a client-centric approach. This inclusive environment offers flexibility, progressive benefits, and meaningful opportunities for impactful work that supports well-being in and out of the office.
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Riveron Consulting is an Equal Opportunity Employer and believes that we are stronger together through our diversity. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, disability status, protected veteran status, sexual orientation, gender identity or any other characteristic protected by law.
Full time roles are eligible for a full range of benefits including medical, dental, and vision insurance, 401(k) with company match, and PTO. A complete description of all available benefits can be found at Riveron's Benefits page at https://riveron.com/riveron-life/. Contract roles are not eligible for benefits.
Fraud Alert
Please beware of fraudulent schemes or impersonations when going through the job application process. A Riveron employee will never recruit via text or extend unsolicited employment offers. Additionally, a Riveron employee will never ask you to exchange money or purchase anything as part of the recruiting process.
Artificial intelligence (AI) tools are used to support the hiring process in screening, assessing, and/or selecting applicants for this position. These tools assist our recruitment team but do not replace human judgment. Final hiring decisions are ultimately made by humans. If you would like more information about how your data is processed, please contact us.

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