Epic Denials Management Operator

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. 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 party payers on open denials, denial appeals, and other outstanding balances related to denials to understand claim status and payer requirements to adjudicate claim. Provide account information to payers and required and resolve issues related to eligibility, authorizations, claim edits, coordination of benefits, and missing documentation. Adhere to defined SOPs and workflows and work within Epic Resolute Hospital Billing, claims clearinghouse, payer websites and portals, and other systems and required by workflows. Meet and exceed minimum productivity and quality standards; submit to performance improvement plans as required according to guidance from engagement management. A successful candidate would possess these skills: 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 The team AI & Engineering leverages cutting-edge engineering capabilities to build, deploy, and operate integrated/verticalized sector solutions in software, data, AI, network, and hybrid cloud infrastructure. These solutions are powered by engineering for business advantage, transforming mission-critical operations. We enable clients to stay ahead with the latest advancements by transforming engineering teams and modernizing technology & data platforms. Our delivery models are tailored to meet each client's unique requirements. Our Industry Solutions offering provides verticalized solutions that transform how clients sell products, deliver services, generate growth, and execute mission-critical operations. We deliver integrated business expertise with scalable, repeatable technology solutions specifically engineered for each sector. Qualifications Required: 2+ 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 Familiarity with Epic Analytics and Reporting applications Ability to travel 10%, on average, based on the work you do and the clients and industries/sectors you serve. Limited immigration sponsorship may be available. Preferred: 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 For individuals assigned and/or hired to work in a remote role, Deloitte is required by law to include a reasonable estimate of the compensation range for this role. This compensation range 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. At Deloitte, it is not typical for an individual to be hired at or near the top of the range for their role and compensation decisions are dependent on the facts and circumstances of each case. A reasonable estimate of the current range is $70,000 to $90,000 with overtime pay possible. You may also be eligible to participate in a discretionary annual incentive program, subject to the rules governing the program, whereby an award, if any, depends on various factors, including, without limitation, individual and organizational performance. Deloitte is committed to providing reasonable accommodations for people with disabilities. If you require a reasonable accommodation to participate in the recruiting process, please direct your inquiries to the Global Call Center (GCC) at View email address on click.appcast.io. Recruiting tips From developing a stand out resume to putting your best foot forward in the interview, we want you to feel prepared and confident as you explore opportunities at Deloitte. Check out recruiting tips from Deloitte recruiters. At Deloitte, we know that great people make a great organization. We value our people and offer employees a broad range of benefits. Learn more about what working at Deloitte can mean for you. Our people and culture Our inclusive culture empowers our people to be who they are, contribute their unique perspectives, and make a difference individually and collectively. It enables us to leverage different ways of thinking, ideas, and perspectives, and bring more creativity and innovation to help solve our clients' most complex challenges. This makes Deloitte one of the most rewarding places to work. Our purpose Deloitte’s purpose is to make an impact that matters for our people, clients, and communities. At Deloitte, purpose is synonymous with how we work every day. It defines who we are. Our purpose comes through in our work with clients that enables impact and value in their organizations, as well as through our own investments, commitments, and actions across areas that help drive positive outcomes for our communities. Learn more. From entry-level employees to senior leaders, we believe there’s always room to learn. We offer opportunities to build new skills, take on leadership opportunities and connect and grow through mentorship. From on-the-job learning experiences to formal development programs, our professionals have a variety of opportunities to continue to grow throughout their career. As used in this posting, "Deloitte" means Deloitte Consulting LLP, a subsidiary of Deloitte LLP. Please see for a detailed description of the legal structure of Deloitte LLP and its subsidiaries. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability or protected veteran status, or any other legally protected basis, in accordance with applicable law. 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