Join Deloitte's AI & Engineering practice to support hospital denials management and back-end Revenue Cycle Management (RCM) services for a healthcare provider client.
This role is primarily remote, with minimal travel and scheduled onsite time as needed. It supports enterprise Epic operations and focuses on denial review, appeal preparation, claim follow-up, and resolution of payer issues.
Responsibilities include:
- Reviewing denials and processing 835/277 remittance information from third-party payers
- Performing denial categorization and root cause analysis
- Reviewing hospital account and payer remittance records
- Communicating with client RCM teams, internal stakeholders, and payers
- Preparing and submitting denial appeal letters using standard templates
- Rebilling corrected claims and routing issues to coding, billing, credentialing, denials, or clinical teams as needed
- Providing additional documentation to payers to support resolution
- Documenting denial research, follow-up activity, and claim status in EMR and patient accounting systems
- Reviewing A/R aging reports and work queues to identify unpaid or delayed claims
- Resolving issues related to eligibility, authorizations, claim edits, coordination of benefits, and missing documentation
Requirements & Qualifications
Required:
- 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
- Limited immigration sponsorship may be available
Preferred:
- 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
Location
Tampa, Florida, US
Employment Type
Full-time
Experience Level
Associate
Salary Range
$50,000 - $60,000
Remote work allowed
Yes
Posted
3 weeks ago