Epic Denials Management Operator
Position Summary
Join Deloitte's AI & Engineering practice to support hospital denials management to 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 health care provider client. This is a primarily remote role supporting enterprise Epic support, with minimal travel and scheduled onsite time as needed.
Recruiting for this role ends on 01/01/2027.
Work you'll do
As an Epic Denials Management Operator on the AI & Engineering team, you will be responsible for supporting review denials (835/277 processing) received from third party payers.
Conduct Denial categorization and root cause analysis based on remittance information received from payer. Review hospital account records and payer remittance records, communicate with relevant Client RCM and internal hospital stakeholders, and conduct outreach to payers through payer portals and phone calls to gather necessary information to understand denial reasons and root causes. Determine appropriate denial responses based on denial reasons. Use appropriate templates to develop denial appeal letters for denials 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 conducted in relevant EMR and patient accounting systems. Review AR aging reports and work queues to identify unpaid and delayed claims. Follow up with third pa...
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