Senior Associate (Revenue Cycle Management)

Responsibilities

• Lead analytical workstreams across RCM engagements focusing on reimbursement performance, denial management, and payer contract compliance
• Conduct comprehensive denial analyses to identify systemic root causes and quantify revenue at risk
• Perform underpayment audits by modeling expected reimbursement against payer contract terms
• Analyze payer contracts to assess reimbursement adequacy and identify rate discrepancies
• Build and maintain dynamic reimbursement models, denial trending dashboards, and KPI scorecards
• Evaluate remittance data and payer adjudication patterns to detect underpayment trends
• Research Medicare, Medicaid, and CMS policy changes to inform advisory recommendations
• Prepare structured analytical exhibits, workpapers, and client-facing deliverables
• Collaborate with the Managing Director and cross-functional teams to execute project workplans

Requirements

• Bachelor’s degree in Finance, Accounting, Health Administration, or related field
• Minimum 3 years of experience in provider and/or payer analytics
• Extensive knowledge of commercial, Medicare, and Medicaid reimbursement methodologies (DRG, APC, RBRVS)
• Deep expertise in denial management, including root cause analysis and appeals
• Proven experience in underpayment identification and payer contract evaluation
• Proficiency in Microsoft Excel for complex financial modeling
• Experience with data analytics tools such as Power BI, Tableau, or SQL
• Working knowledge of EHR systems like EPIC, Cerner, or Athenahealth
• Familiarity with CPT, ICD-10, HCPCS, and revenue code conventions
• Experience in a consulting, advisory, or professional services environment

About the Company

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.