The Risk Prevention Analyst is responsible for providing operational risk assessments leveraging fraud mitigation tools, focusing on analysis, design, and artificial intelligence (AI) technology ...
The Risk Prevention Analyst is responsible for providing operational risk assessments leveraging fraud mitigation tools, focusing on analysis, design, and artificial intelligence (AI) technology ...
Denials Management Expert - AI Tools
San Francisco, CA · Remote
$93/hr
Remote Role Responsibilities * Lead denials management and appeals operations. Oversee the ... Evaluate AI-generated appeal letters, denial root cause analyses, and denial prevention ...
Quick apply
Denials Management Expert - AI Tools
San Francisco, CA · Remote
$93/hr
Remote Role Responsibilities * Lead denials management and appeals operations. Oversee the ... Evaluate AI-generated appeal letters, denial root cause analyses, and denial prevention ...
Appeals Manager - AI Trainer
Dallas, TX · Remote
$70 - $93/hr
Remote Role Responsibilities * Lead denials management and appeals operations. Oversee ... Evaluate AI-generated appeal letters, denial root cause analyses, and denial prevention ...
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Appeals Manager - AI Trainer
Dallas, TX · Remote
$70 - $93/hr
Remote Role Responsibilities * Lead denials management and appeals operations. Oversee ... Evaluate AI-generated appeal letters, denial root cause analyses, and denial prevention ...
Senior Revenue Cycle Analyst (CA)
$80K - $121K/yr
... denial prevention strategies. The Senior Analyst serves as a key analytical resource, translating performance data into operational recommendations that align with regional and system revenue cycle ...
Senior Revenue Cycle Analyst (CA)
$80K - $121K/yr
... denial prevention strategies. The Senior Analyst serves as a key analytical resource, translating performance data into operational recommendations that align with regional and system revenue cycle ...
Senior Revenue Cycle Analyst (CA)
$80K - $121K/yr
... denial prevention strategies. The Senior Analyst serves as a key analytical resource, translating performance data into operational recommendations that align with regional and system revenue cycle ...
Senior Revenue Cycle Analyst (CA)
$80K - $121K/yr
... denial prevention strategies. The Senior Analyst serves as a key analytical resource, translating performance data into operational recommendations that align with regional and system revenue cycle ...
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 ...
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 ...
... 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 ...
Quick apply
... 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 ...
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 ...
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 ...
... denial prevention efforts and initiatives that ensure accurate billing, regulatory coding ... analysis and one (1) of the certifications listed. A Bachelor's degree in Finance, Healthcare ...
... denial prevention efforts and initiatives that ensure accurate billing, regulatory coding ... analysis and one (1) of the certifications listed. A Bachelor's degree in Finance, Healthcare ...
... denial prevention efforts and initiatives that ensure accurate billing, regulatory coding ... analysis and one (1) of the certifications listed. A Bachelor's degree in Finance, Healthcare ...
... denial prevention efforts and initiatives that ensure accurate billing, regulatory coding ... analysis and one (1) of the certifications listed. A Bachelor's degree in Finance, Healthcare ...
Support denial prevention activities and assist with appeals processes when appropriate * Apply ... Demonstrated analytical, critical thinking, and problem-solving skills * Effective verbal and ...
New
Support denial prevention activities and assist with appeals processes when appropriate * Apply ... Demonstrated analytical, critical thinking, and problem-solving skills * Effective verbal and ...
New
Denials Liaison
Somerville, MA · On-site +1
$63K - $92K/yr
... analysts to advance our mission. As a not-for-profit, we support patient care, research, teaching ... Job Summary Under the direction of the Sr. Manager - Denial Prevention & Training, the Denials ...
Denials Liaison
Somerville, MA · On-site +1
$63K - $92K/yr
... analysts to advance our mission. As a not-for-profit, we support patient care, research, teaching ... Job Summary Under the direction of the Sr. Manager - Denial Prevention & Training, the Denials ...
Denials Liaison
Somerville, MA · Remote
$63K - $92K/yr
... analysts to advance our mission. As a not-for-profit, we support patient care, research, teaching ... Job Summary Under the direction of the Sr. Manager - Denial Prevention & Training, the Denials ...
Denials Liaison
Somerville, MA · Remote
$63K - $92K/yr
... analysts to advance our mission. As a not-for-profit, we support patient care, research, teaching ... Job Summary Under the direction of the Sr. Manager - Denial Prevention & Training, the Denials ...
Support denial prevention activities and assist with appeals processes when appropriate * Apply ... Demonstrated analytical, critical thinking, and problem-solving skills * Effective verbal and ...
New
Support denial prevention activities and assist with appeals processes when appropriate * Apply ... Demonstrated analytical, critical thinking, and problem-solving skills * Effective verbal and ...
New
Work Style: Remote ???? Location Requirement: Must reside in Florida or Georgia ???? FTE ... to prevent filing deadlines. * Evaluates accounts using remittances, denial reason codes, remark ...
Work Style: Remote ???? Location Requirement: Must reside in Florida or Georgia ???? FTE ... to prevent filing deadlines. * Evaluates accounts using remittances, denial reason codes, remark ...
Analyze denial trends and identify root causes to improve claim outcomes. * Support reduction of ... Provide guidance and training to BPO teams on claims processing and denial prevention best ...
Analyze denial trends and identify root causes to improve claim outcomes. * Support reduction of ... Provide guidance and training to BPO teams on claims processing and denial prevention best ...
Support denial prevention activities and assist with appeals processes when appropriate * Apply ... Demonstrated analytical, critical thinking, and problem-solving skills * Effective verbal and ...
New
Support denial prevention activities and assist with appeals processes when appropriate * Apply ... Demonstrated analytical, critical thinking, and problem-solving skills * Effective verbal and ...
New
Support denial prevention activities and assist with appeals processes when appropriate * Apply ... Demonstrated analytical, critical thinking, and problem-solving skills * Effective verbal and ...
New
Support denial prevention activities and assist with appeals processes when appropriate * Apply ... Demonstrated analytical, critical thinking, and problem-solving skills * Effective verbal and ...
New
Utilization Review RN (Remote)
Fort Lauderdale, FL · Remote
$80K - $100K/yr
Support denial prevention, documentation improvement, and revenue cycle initiatives * Ensure ... Analyze clinical and financial data to identify quality improvement opportunities Compensation:
Quick apply
Utilization Review RN (Remote)
Fort Lauderdale, FL · Remote
$80K - $100K/yr
Support denial prevention, documentation improvement, and revenue cycle initiatives * Ensure ... Analyze clinical and financial data to identify quality improvement opportunities Compensation:
Analyze denial trends and identify root causes to improve claim outcomes. * Support reduction of ... Provide guidance and training to BPO teams on claims processing and denial prevention best ...
Analyze denial trends and identify root causes to improve claim outcomes. * Support reduction of ... Provide guidance and training to BPO teams on claims processing and denial prevention best ...
Remote Denial Prevention Analyst information
See salary details
$33K - $39.6K
5% of jobs
$39.6K - $46.2K
1% of jobs
$46.2K - $52.8K
4% of jobs
$52.8K - $59.4K
0% of jobs
$59.4K - $66K
5% of jobs
$66K - $72.5K
6% of jobs
$74.9K is the 25th percentile. Wages below this are outliers.
$72.5K - $79.1K
7% of jobs
The median wage is $83K / yr.
$79.1K - $85.7K
34% of jobs
$89.8K is the 75th percentile. Wages above this are outliers.
$85.7K - $92.3K
18% of jobs
$92.3K - $98.9K
9% of jobs
$98.9K - $105.5K
10% of jobs
$33K
$80.8K
$105.5K
How much do remote denial prevention analyst jobs pay per year?
What is the difference between Remote Denial Prevention Analyst vs Remote Claims Specialist?
| Aspect | Remote Denial Prevention Analyst | Remote Claims Specialist |
|---|---|---|
| Primary Focus | Preventing claim denials through analysis and process improvements | Processing and adjudicating insurance claims |
| Required Credentials | Knowledge of insurance policies, certifications like CPC or CPC-A beneficial | Similar credentials, often CPC or medical billing certifications |
| Work Environment | Remote, healthcare or insurance companies | Remote, insurance or healthcare organizations |
| Industry Usage | Insurance, healthcare, medical billing | Insurance, 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 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:
What states have the most Remote Denial Prevention Analyst jobs?
States with the most job openings for Remote Denial Prevention Analyst jobs include:
What job categories do people searching Remote Denial Prevention Analyst jobs look for?
The top searched job categories for Remote Denial Prevention Analyst jobs are:

Full-time
Medical, Dental, Vision, Life, Retirement, PTO
Re-posted 24 days ago
Velera rating
8.7
Based on 24 frontline employees who took The Breakroom Quiz
25th of 225 rated it services
Job description
Velera is the nation's premier payments credit union service organization (CUSO) and an integrated fintech solutions provider. The company serves more than 4,000 financial institutions throughout North America, operating with velocity to help our clients keep pace with the rapid momentum of change and fuel growth in the new era of financial services. Our purpose: We accelerate partners' success through innovative financial technology solutions and inspired service.
The Opportunity:
The Risk Prevention Analyst is responsible for providing operational risk assessments leveraging fraud mitigation tools, focusing on analysis, design, and artificial intelligence (AI) technology associated with fraud mitigation strategies, call queue creation, monitoring, support, and management using quantitative methods to review data and increase efficiency, productivity, effectiveness and savings. Seeking a skilled Risk Analyst who will provide support for external clients and internal staff on fraud detection and prevention matters, inquiries, and solutions to meet client and business needs. Additionally, the role involves writing rules and creating custom solutions for clients, monitoring fraud for their client group, identifying risk exposure based on fraud trends and data, and determining mitigation measures. This role involves direct interaction with senior-level management at the financial institution and within Velera, as well as regular coordination with the Fraud Detection Work Center (FDWC), Velera Service Centers, multiple internal departments, and 3rd party vendor personnel.
Day in the Life:
Develop and implement Fraud strategies leveraging transaction data (credit/debit cards), machine learning models and advanced analytics tools to mitigate fraud losses and maintain superior customer experience.
Manage and optimize existing strategies effectively controlling risks due to first party and third-party fraud. Design, tests and understand the risk and customer experience trade-offs.
Coordinate the Risk Analytics team's tasks and ensure adherence to established turnaround times and SLAs; manage projects assigned to the team; Ensure quality of all team outputs.
Maintain awareness of member client fraud trends and suggest internal procedure changes to Risk Analytics Manager to remain efficient.
Continually supervise department workflow to ensure time-sensitive functions meet department standards.
Maintains productive relationships with all internal stakeholders including Fraud Operations, Risk Management, Product, Retail, Finance as well as external vendors
Advise internal contacts on sensitive issues and recommend client procedures and new product developments.
Maintains productive relationships with all internal stakeholders including Fraud Operations, Risk Management, Product, Retail, Finance as well as external vendors.
Create and deliver BI reporting to develop thorough reporting for senior leadership, boards, and examiners.
Work closely with a designated client list to ensure efficient and effective fraud mitigation through various communication channels such as calls and emails.
Uses advanced business, analytical and technical knowledge to participate in discussions with cross functional teams to understand and collaborate on business objectives and influence solution strategies.
Translates recommendation into communication materials to effectively present to colleagues for peer review and mid-to-upper-level management. Incorporates visualization techniques to support the relevant points of the analysis and ease the understanding for less technical audiences.
Identifies and gathers the relevant and quality data sources required to fully answer and address the problem for the recommended strategy through testing or exploratory data analysis (EDA).
Integrates/transforms disparate data sources and resolves appropriate data hygiene techniques to apply.Consults external clients and internal staff on fraud detection and prevention matters, inquiries, and solutions to meet client and business needs. Writes rules, builds custom solutions for clients, and monitors fraud for their client group.
Identifies risk exposure associated with fraud trends that have the potential to cause financial losses and poor member experience in client portfolios to determine if mitigation measures are necessary.
Monitor and analyze portfolio performance on an ongoing basis. Identify trends and conduct root-cause analysis to isolate key performance drivers and combine the insights with a data-driven approach to develop fraud defenses.
Leverages knowledge of fraud prevention tools to consult with clients on their fraud and risk goals, review key fraud performance metrics, consult on available fraud tools, and recommend strategic means to minimize risk exposure and improve member experience.
Collaborate with other internal teams to serve as client advocate for fraud and risk items and special projects or mitigations.
Ensure risks associated with business activities are effectively identified, measured, monitored, and controlled in accordance with risk and compliance policies and procedures.
Responsible for reporting risks identified to the appropriate team and/or management.
Additionally, responsible for managing, monitoring and reporting risks within your work area's scope, including, but not limited to Information Security risks.
Regular and reliable attendance is required. Some on-call work is required.
This position may require early/late hours and availability during weekends to ensure client support on fraud monitoring or mitigation.
Bring innovative/out of the box thinking to solve problems and make recommendations.
Functional knowledge of common fraud patterns with endless curiosity to seek out anomalies and get to the core of a problem.
The ability to prioritize and make quick decisions under tight deadlines
Remain current with industry and client fraud trends.
Perform other duties as assigned.
Qualifications:
Bachelor's degree in Business, Statistics, Mathematics, Computer Science, Engineering or Economics or related field or combination of education and experience required.
Five (5) years within the financial service industry required.
Three (3) years professional experience in risk analytics, mitigating risk and/or fraud services required.
Payments processing system knowledge preferred.
Experience with, , Fraud Detection Work Center and/or FDR system experience required.
Strong analytical and problem-solving skills. Deep experience working with fraud detection strategies, rules tuning, and fraud modeling.
Strong proficiency with SQL; Ability to analyze large, complex datasets and derive actionable insights.
Experience with fraud orchestration and decisioning tools (e.g., DefenseEdge, Falcon, Advance Defense, Fraud Navigator) preferred.
Strong understanding of fraud metrics, forecasting methods, and false positive/true fraud tradeoffs.
Excellent problem-solving skills with the ability to synthesize complex data into actionable insights.
Strong communication skills - ability to communicate technical subject matter clearly and succinctly to other team members and financial institutions.
Project management experience preferred.
About Velera
At Velera, inclusion isn't an initiative - it's how we work. Guided by a peoplehelpingpeople philosophy, we cultivate a culture where every employee feels valued, respected and empowered to do their best work. We're committed to building a diverse workforce and fostering meaningful connection across our teams. Through a remotefirst, flexible environment, we prioritize psychological safety, wellbeing and belonging so individuals and teams can collaborate to thrive. Together, we're shaping a new era of secure, innovative solutions for the clients and communities we serve. Learn more about what it's like to work at Velera.
Pay Equity
$60,500.00 - $77,100.00Actual Pay will be adjusted based on experience and other job-related factors permitted by law.
Great Work/Life Benefits!
Competitive wages
Medical with telemedicine
Dental and Vision
Basic and Optional Life Insurance
Paid Time Off (PTO)
Maternity, Parental, Family Care
Community Volunteer Time Off
12 Paid Holidays
Company Paid Disability Insurance
401k (with employer match)
Health Savings Accounts (HSA) with company provided contributions
Flexible Spending Accounts (FSA)
Supplemental Insurance
Mental Health and Well-being: Employee Assistance Program (EAP)
Tuition Reimbursement
Wellness program
Benefits are subject to generally applicable eligibility, waiting period, contribution, and other requirements and conditions
Velera is an Equal Opportunity Employer. We consider applicants without regard to race, color, religion, age, national origin, ancestry, ethnicity, gender, gender identity, gender expression, sexual orientation, marital status, veteran status, disability, genetic information, citizenship status, or membership in any other group protected by federal, state or local law.
Velera is an Equal Opportunity Employer that complies with the laws and regulations set forth in the following"EEO is the Law" Poster. Velera will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the legal duty to furnish information.
Velera is an E-Verify Employer. Review the E-Verify Poster here. For information regarding your Right To Work, please click here.
This role is currently not eligible for sponsorship.
As an ongoing commitment to reasonably accommodate individuals with disabilities please contact a recruiter at recruiters@velera.com for assistance.
About Velera
Sourced by ZipRecruiter
Industry
Finance and insurance
Company size
1,001 - 5,000 Employees
Headquarters location
Rancho Cucamonga, CA, US