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 Epic Denials Management Coordinator on the AI & Engineering team supports 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. The role involves determining appropriate denial responses based on denial reasons, developing denial appeal letters, rebilling corrected claims, and resolving denial issues by providing additional documentation to payers and documenting denial details, research conducted, and follow-up activities conducted in relevant EMR and patient accounting systems.
Responsibilities
- Conduct Denial Categorization and Root Cause Analysis
- Communicate with Relevant Stakeholders
- Develop Denial Appeal Letters
- Rebill Corrected Claims
- Resolve Denial Issues Through Additional Documentation
- Document Denial Details and Follow-Up Activities
- Review AR Aging Reports and Work Queues
- Follow Up with Third Party Payers
- Provide Account Information and 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% Based on Work Done and Clients Served
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 current range being $50,000 to $60,000 with overtime pay possible. Additionally, there may be opportunities for participation in a discretionary annual incentive program, contingent upon individual and organizational performance.