Denial Management Specialist – Orthopedic Services

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🐊 Florida – Remote

🐊 Florida – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

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HCCS - Healthcare Coding & Consulting Services

WebsiteLinkedInAll Job Openings

201 - 500 employees

Founded 2006

🤝 B2B

📋 Compliance

B2B • Compliance

HCCS - Healthcare Coding & Consulting Services is a US-based provider of remote medical coding, documentation auditing, clinical documentation improvement (CDI), DRG clinical validation, HIM services, and interface/EHR support for healthcare providers. They employ only US-based, W-2 coders and auditors and emphasize coding accuracy, regulatory/compliance-focused audits, and integration with common EHR systems (EPIC, Meditech, CPSI). HCCS serves hospitals and healthcare partners with B2B services and also hires and trains coding professionals.

📋 Description

• Support orthopedic revenue cycle and denial management operations • Understand the full revenue cycle, including coding, claim submission, payer follow-up, denial resolution, and appeals • Initially focus on orthopedic denials and ERISA appeals • Support billing, coding, accounts receivable, claims follow-up, and denial management needs across multiple specialties

🎯 Requirements

• CPC, CCS, CPMA, or similar certification preferred, but not required • CPB certification preferred • Minimum of three years of professional healthcare revenue cycle experience • Professional experience in both medical billing and medical coding required • Experience with denial management, claims resolution, accounts receivable follow-up, appeals, or payer correspondence • Experience with Epic, Athena, NextGen, eClinicalWorks, or comparable healthcare systems • Knowledge of CPT, HCPCS, ICD-10-CM, modifiers, NCCI edits, medical necessity requirements, and payer reimbursement policies • Experience working with commercial insurance, Medicare, Medicaid, self-funded health plans, payer portals, and claim follow-up workflows • Ability to review medical records, claims, EOBs, remittance advice, and payer correspondence to identify billing and coding issues • Strong written communication skills with experience preparing professional appeal letters • Strong analytical, organizational, and problem-solving abilities • Ability to independently manage a high-volume workload and meet payer deadlines • Proficiency in Microsoft Excel, Word, and Outlook.

🏖️ Benefits

• Comprehensive benefits • Supportive leadership • Opportunities for professional growth • Stable, long-term employment