Revenue Cycle Data Analyst - FT - Day - Revenue Integrity & Denials Mgmt Lawrenceville NJ

Capital Health is the region's leader in providing progressive, quality patient care with significant investments in our exceptional physicians, nurses and staff, as well as advanced technology. Capital Health is a dynamic health care resource accredited by the DNV that includes two hospitals, an outpatient center, satellite ED, and an expansive network of primary and specialty care. Capital Health Medical Group is made up of more than 600 physicians and other providers who offer primary and specialty care, as well as hospital-based services, to patients throughout the region.

Capital Health recognizes that attracting the best talent is key to our strategy and success as an organization. As a result, we aim for flexibility in structuring competitive compensation offers to ensure we can attract the best candidates.

The listed pay range or pay rate reflects compensation for a full-time equivalent (1.0 FTE) position. Actual compensation may differ depending on assigned hours and position status (e.g., part-time).

Pay Range:

$64,625.60 - $84,448.00

Scheduled Weekly Hours:

40

Position Overview

Responsible for delivering accurate, actionable reporting and insights across Revenue Cycle leadership, with a primary focus on Revenue Integrity and Denials Management. Supports operational and executive decision-making by identifying trends, quantifying revenue risk/opportunity, and tracking performance across pre-bill, claim adjudication, denial, and appeal workflows. Partners with clinical, billing, coding, case management, and finance teams to improve data visibility, reduce avoidable denials, and strengthen end-to-end revenue cycle performance.

MINIMUM REQUIREMENTS
Education:    Bachelor’s degree in healthcare administration, Finance, Business, Data Analytics, or related field.
Experience:    Three years' experience in healthcare revenue cycle, revenue integrity, denials, reimbursement analytics, or related financial/operational analytics role.
Other Credentials:    
Knowledge and Skills:    Strong analytical skills with the ability to interpret complex healthcare claims and reimbursement data. Advanced proficiency in Excel (pivot tables, lookups, formulas, data validation). Experience creating reports and dashboards for leadership audiences. Strong communication skills with ability to translate data into clear business insights and recommendations.
Special Training:    
Mental, Behavioral and Emotional Abilities:    Must have ability to meet deadlines and attention to detail. Must demonstrate good judgment. Must be metric-driven and results oriented.
Usual Work Day:    8 Hours  
Reporting Relationships
Does this position formally supervise employees? No

If set to YES, then this position has the authority (delegated) to hire, terminate, discipline, promote or effectively recommend such to manager.

ESSENTIAL FUNCTIONS
Develop, maintain, and distribute recurring and ad hoc revenue cycle reports for leadership and operational teams.
Builds dashboards and scorecards focused on denial trends, appeal performance, underpayments, pre-bill edits/holds, and revenue integrity outcomes.
Analyzes root causes of denials by payer, denial reason, service line, DRG, location, and workflow ownership.
Monitor and report key KPIs, including (as applicable): Initial denial rate, Preventable denial rate, Appeal overturn rate, Days to appeal submission/resolution, DNFB aging and pre-bill hold impact, Net collections and reimbursement variance trends.
Support denials task force and revenue integrity governance by preparing meeting materials, trend summaries, and action-oriented insights.
Reconciles data across source systems (EMR, billing, clearinghouse, denials/work queue tools) and validate report accuracy.
Monitors charge capture performance and identify potential revenue leakage across inpatient and outpatient workflows, including missed charges, late charges, charge lag, and documentation-to-bill discrepancies.
Analyzes trends in late charges and post-bill adjustments; quantify financial impact and partner with clinical and operational leaders to strengthen charge capture controls and reduce avoidable revenue loss.
Partners with leaders to define metric logic, data definitions, and reporting standards.
Identifies process breakdowns and collaborate with operations on corrective action tracking and follow-up reporting.
Assists with payer policy impact analyses and retrospective reviews to quantify financial and operational impact.
Contributes to annual goal setting, baseline development, and performance monitoring across revenue cycle priorities.
Perform other duties as assigned.

PHYSICAL DEMANDS AND WORK ENVIRONMENT
Frequent physical demands include: Standing , Walking , Talk or Hear

Occasional physical demands include: Climbing (e.g., stairs or ladders) , Carry objects , Push/Pull , Twisting , Bending , Reaching forward , Reaching overhead , Squat/kneel/crawl , Wrist position deviation

Continuous physical demands include: Sitting , Pinching/fine motor activities , Keyboard use/repetitive motion

Lifting Floor to Waist 20 lbs. Lifting Waist Level and Above 10 lbs.

Sensory Requirements include: Very Accurate 20/40, Near Vision, Accurate Far Vision, Color Discrimination, Minimal Depth Perception, Minimal Hearing
Anticipated Occupational Exposure Risks Include the following: N/A

This position is eligible for the following benefits:

• Medical Plan

• Prescription drug coverage & In-House Employee Pharmacy

• Dental Plan

• Vision Plan

• Flexible Spending Account (FSA)

- Healthcare FSA

- Dependent Care FSA

• Retirement Savings and Investment Plan

• Basic Group Term Life and Accidental Death & Dismemberment (AD&D) Insurance

• Supplemental Group Term Life & Accidental Death & Dismemberment Insurance

• Disability Benefits – Long Term Disability (LTD)

• Disability Benefits – Short Term Disability (STD)

• Employee Assistance Program

• Commuter Transit

• Commuter Parking

• Supplemental Life Insurance

- Voluntary Life Spouse

- Voluntary Life Employee

- Voluntary Life Child

• Voluntary Legal Services

• Voluntary Accident, Critical Illness and Hospital Indemnity Insurance

• Voluntary Identity Theft Insurance

• Voluntary Pet Insurance

• Paid Time-Off Program

The pay range listed is a good faith determination of potential base compensation that may be offered to a successful applicant for this position at the time of this job advertisement and may be modified in the future. When determining base salary and/or rate, several factors may be considered including, but not limited to location, years of relevant experience, education, credentials, negotiated contracts, budget, market data, and internal equity. Bonus and/or incentive eligibility are determined by role and level.

The salary applies specifically to the position being advertised and does not include potential bonuses, incentive compensation, differential pay or other forms of compensation, compensation allowance, or benefits health or welfare. Actual total compensation may vary based on factors such as experience, skills, qualifications, and other relevant criteria.