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.

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
• Resolve Denial Issues
• Document Details and Follow-Up Activities
• Review AR Aging Reports and Work Queues
• Follow Up with Third Party Payers
• Provide Account Information to Payers
• Manage Multiple Tasks in a Fast-Paced Environment

Requirements

• Ability to Work Independently and Collaborate
• Effective Written and Verbal Communication Skills
• Meticulous Attention to Detail and Quality of Work Product
• Build and Sustain Professional Relationships
• Manage and Prioritize Multiple Tasks
• Meet Deadlines

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 Related Field; or Equivalent Experience
• Experience Working in Claims Clearinghouse Systems
• Ability to Travel 10% Based on Work Done and Clients/Industries Served
• Reasonable Estimate of Compensation Range: $50,000 to $60,000 with Overtime Pay Possible