[Hiring] Epic Denials Management Coordinator @Deloitte

Role Description

Join Deloitte’s AI & Engineering practice to support hospital denials management to deliver back-end Revenue Cycle Management (RCM) services, including:

• Billing and Claims Submission
• A/R Follow-up
• Denials Management
• Payment Posting
• Credits and Refunds

This is a primarily remote role supporting enterprise Epic support, with minimal travel and scheduled onsite time as needed.

As an Epic Denials Management Coordinator on the AI & Engineering team, you will be responsible for:

• Supporting review denials (835/277 processing) received from third party payers.
• Conducting denial categorization and root cause analysis based on remittance information received from payer.
• Reviewing hospital account records and payer remittance records.
• Communicating with relevant Client RCM and internal hospital stakeholders.
• Conducting outreach to payers through payer portals and phone calls to gather necessary information.
• Determining appropriate denial responses based on denial reasons.
• Using appropriate templates to develop denial appeal letters for denials and submit to third party payers.
• Rebilling corrected claims and routing issues to coding, billing, credentialing, denials, and/or clinical teams as needed.
• Providing additional documentation to payers as needed to resolve denial issues.
• Documenting denial details, research conducted, and follow-up activities in relevant EMR and patient accounting systems.
• Reviewing AR aging reports and work queues to identify unpaid and delayed claims.
• Following up with third party payers on open denials, denial appeals, and other outstanding balances related to denials.
• Providing account information to payers and resolving issues related to eligibility, authorizations, claim edits, coordination of benefits, and missing documentation.
• Adhering to defined SOPs and workflows.
• Meeting and exceeding minimum productivity and quality standards.

Qualifications

• 1+ years of experience in hospital account denial management and appeals.
• Experience using Epic Resolute Hospital Billing.
• Bachelor's degree in information technology, business, healthcare, or a related field; or equivalent experience.
• Experience working in claims clearinghouse systems.
• Ability to travel 10%, on average, based on the work you do and the clients and industries/sectors you serve.
• Limited immigration sponsorship may be available.

Requirements

• Experience using Microsoft Word, Excel, and PowerPoint.
• Experience supporting clinical or healthcare business operations.
• Experience managing multiple projects or workstreams.
• Experience preparing and delivering technical demonstrations.
• Experience analyzing billing workflows, claim issues, or operational data.

Benefits

• Broad range of benefits offered to employees.
• Opportunity to participate in a discretionary annual incentive program, subject to rules governing the program.