Epic Denials Management Operator

Join Deloitte's AI & Engineering practice to support hospital denials management and back-end Revenue Cycle Management (RCM) services, including billing, claims submission, A/R follow-up, denials management, payment posting, and credits and refunds for a health care provider client.

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

As an Epic Denials Management Operator, you will support review of denials (835/277 processing) received from third-party payers. You will conduct denial categorization and root cause analysis, review hospital account and payer remittance records, communicate with client RCM and hospital stakeholders, and work with payers through portals and phone calls to gather information needed to understand denial reasons.

You will determine appropriate denial responses, develop 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. You will also document denial details, research, and follow-up activity in EMR and patient accounting systems, review A/R aging reports and work queues, and follow up on open denials and outstanding balances to understand claim status and payer requirements.

The role requires working within Epic Resolute Hospital Billing, claims clearinghouse systems, payer websites and portals, and other workflow-driven systems while meeting productivity and quality standards.