Epic Denials Management Operator

Join Deloitte's AI & Engineering practice to support hospital denials management and back-end revenue cycle management services, including billing and claims submission, accounts receivable follow-up, denials management, payment posting, and credits and refunds, for a health care provider client.

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

In this role, you will support review of denials received from third-party payers, perform denial categorization and root cause analysis, communicate with client and hospital stakeholders, and outreach to payers through portals and phone calls to gather information needed to understand denial reasons.

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 payers to resolve denial issues.

You will also document denial details, research, and follow-up activities in EMR and patient accounting systems, review AR aging reports and work queues to identify unpaid and delayed claims, and follow up on open denials, appeals, and outstanding balances to understand claim status and payer requirements.

Work will be performed in Epic Resolute Hospital Billing, claims clearinghouse systems, payer websites and portals, and related systems in accordance with SOPs and workflows.