Denial Management Specialist

To support orthopedic services, the full-time Denial Management Specialist will manage denial appeals, analyze claims data, and collaborate with healthcare teams in a remote setting. Key responsibilities Supporting orthopedic revenue cycle and denial management operations Working the full revenue cycle, including coding, claim submission, payer follow-up, denial resolution, and appeals Focusing on orthopedic denials and ERISA appeals Required qualifications 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