Denial Management Specialist – Orthopedic Services

Healthcare Coding & Consulting Services (HCCS) is seeking an experienced Denial Management Specialist with a strong background in both medical billing and medical coding. This is a fully remote, full-time position supporting orthopedic revenue cycle and denial management operations. The ideal candidate understands the full revenue cycle, including coding, claim submission, payer follow-up, denial resolution, and appeals. Although this role will initially focus on orthopedic denials and ERISA appeals, candidates must be flexible and comfortable supporting billing, coding, accounts receivable, claims follow-up, and denial management needs across multiple specialties. At HCCS, all team members are direct-hire W-2 employees. We offer stable, long-term employment, comprehensive benefits, supportive leadership, and opportunities for professional growth. We proudly keep all coding and revenue cycle services within the United States. Position 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. Joining HCCS means becoming part of a family-owned company with nearly 20 years of experience serving healthcare organizations across the country. We are committed to providing long-term career stability through full-time, remote W-2 employment. Our team members enjoy competitive compensation, a comprehensive benefits package, supportive leadership, and opportunities for professional growth. You'll have the opportunity to make a meaningful impact while partnering with some of the nation's leading healthcare organizations and collaborating with experienced professionals who are committed to quality, integrity, and excellence.