Epic Denials Management Operator

Join Deloitte's AI & Engineering practice to support hospital denials management and deliver back-end Revenue Cycle Management (RCM) services, including billing and claims submission, A/R follow-up, denials management, payment posting, and credits and refunds, for a healthcare provider client. This role is primarily remote, with minimal travel and scheduled onsite time as needed.

You will support review of denials (835/277 processing) received from third-party payers. Responsibilities include denial categorization and root cause analysis, reviewing hospital account and payer remittance records, communicating with client RCM teams and hospital stakeholders, and contacting payers through portals and phone calls to gather needed information.

You will determine appropriate denial responses, prepare and submit appeal letters, rebill corrected claims, route issues to coding, billing, credentialing, denials, and clinical teams as needed, and provide additional documentation to resolve denial issues. The role also includes documenting denial details and follow-up activities in EMR and patient accounting systems, reviewing A/R aging reports and work queues, and following up on open denials, appeals, and outstanding balances.

Work will be performed within Epic Resolute Hospital Billing, claims clearinghouse systems, payer websites, and other required systems while adhering to SOPs and workflows. Productivity and quality standards must be met and maintained.