Epic Denials Management Coordinator
Deloitte
About the Role
Join Deloitte's AI & Engineering practice to support hospital denials management for healthcare provider clients. This is a primarily remote role supporting enterprise Epic support.
Key Responsibilities
- Support review of denials (835/277 processing) received from third party payers.
- Conduct denial categorization and root cause analysis based on remittance information.
- Review hospital account records and payer remittance records.
- Communicate with relevant Client RCM and internal hospital stakeholders.
- Conduct outreach to payers through payer portals and phone calls to gather information on denial reasons and root causes.
- Determine appropriate denial responses based on denial reasons.
- Develop denial appeal letters using appropriate templates and submit to third party payers.
- Rebill corrected claims and route issues to coding, billing, credentialing, denials, and/or clinical teams as needed.
- Provide additional documentation to payers as needed to resolve denial issues.
- Document denial details, research conducted, and follow-up activities in relevant EMR and patient accounting systems.
- Review AR aging reports and work queues to identify unpaid and delayed claims.
- Follow up with third party payers on open denials, denial appeals, and other outstanding balances to understand claim status and payer requirements.
- Provide account information to payers and resolve issues related to eligibility, authorizations, claim edits, coordination of benefits, and missing documentation.
- Adhere to defined SOPs and workflows.
- Work within Epic Resolute Hospital Billing, claims clearinghouse, payer websites and portals, and other systems.
- Meet and exceed minimum productivity and quality standards.
Requirements & Tech Stack
- Ability to work independently and collaborate as part of a team
- Effective written and verbal communication skills
- Meticulous attention to detail and quality of work product
- Ability to build and sustain professional relationships
- Ability to manage and prioritize multiple tasks in a fast-paced and dynamic environment
- Strong interpersonal skills and professional demeanor
- Ability to meet deadlines
- Epic Resolute Hospital Billing
- Claims clearinghouse systems
- Payer websites and portals
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.
Limited immigration sponsorship may be available.
Preferred Qualifications
- 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