Epic Denials Management Coordinator
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.
About the Role
The role involves supporting review denials (835/277 processing) received from third party payers. Responsibilities include conducting Denial categorization and root cause analysis based on remittance information received from payer, reviewing hospital account records and payer remittance records, communicating with relevant Client RCM and internal hospital stakeholders, and conducting outreach to payers through payer portals and phone calls to gather necessary information to understand denial reasons and root causes. Determining appropriate denial responses based on denial reasons, developing denial appeal letters, rebilling corrected claims, and resolving denial issues are also part of the responsibilities.
Responsibilities
- Conduct Denial Categorization and Root Cause Analysis
- Communicate with Relevant Stakeholders
- Conduct Outreach to Payers
- Determine Appropriate Denial Responses
- Develop Denial Appeal Letters
- Rebill Corrected Claims
- Route Issues to Coding, Billing, Credentialing, Denials, and/or Clinical Teams
- Document Denial Details, Research Conducted, and Follow-Up Activities
- Review AR Aging Reports and Work Queues
- Follow Up with Third Party Payers
- Provide Account Information to Payers
- Resolve Issues Related to Eligibility, Authorizations, Claim Edits, Coordination of Benefits, and Missing Documentation
- Adhere to Defined SOPs and Workflows
- Meet and Exceed Minimum Productivity and Quality Standards
Requirements
- 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, Based on the Work You Do and the Clients and Industries/Sectors You Serve
Qualifications
- 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
Benefits
Deloitte offers a competitive compensation package, including a reasonable estimate of the compensation range for this role, which is specific to the remote role and takes into account the wide range of factors that are considered in making compensation decisions including but not limited to skill sets; experience and training; licensure and certifications; and other business and organizational needs. A reasonable estimate of the current range is $50,000 to $60,000 with overtime pay possible.
Pay
Reasonable Estimate: $50,000 - $60,000 per year
Schedule
Primarily Remote Role with Minimal Travel and Scheduled Onsite Time as Needed