Fully remote, full-time opportunity for an experienced Pro Clinic Coding Denial Specialist supporting orthopedic denial management and appeals. The role focuses on resolving coding-related denials, researching reimbursement issues, and preparing effective appeals to maximize payment.
This position requires strong knowledge of professional fee coding, medical billing, and the healthcare revenue cycle, along with the ability to review claims, medical records, and payer correspondence to identify and resolve discrepancies.
Requirements & Qualifications
- AAPC and/or AHIMA certification required; CPC, CCS, CPMA, or CPB preferred
- Minimum 3 years of Pro Clinic (Outpatient E/M) experience
- Minimum 3 years of experience with coding-related denials, appeals, and reimbursement issues
- Strong understanding of the healthcare revenue cycle, including billing, claims processing, accounts receivable, and payer reimbursement
- Professional experience in both medical coding and medical billing
- Experience reviewing medical records, claims, EOBs, remittance advice, and payer correspondence
- Thorough knowledge of CPT, HCPCS, ICD-10-CM, modifiers, NCCI edits, medical necessity guidelines, and payer reimbursement policies
- Experience with commercial insurance, Medicare, Medicaid, and managed care payers
- Experience preparing and submitting professional appeal letters
- Experience with Epic, Athena, NextGen, eClinicalWorks, or similar EHR/practice management systems
Benefits & Perks
- Full-time remote W-2 employment
- Competitive compensation
- Comprehensive benefits package
- Supportive leadership
- Opportunities for professional growth
- Long-term career stability
- Family-owned company culture
Location
Florida, US
Employment Type
Full-time
Experience Level
Intermediate Level
Remote work allowed
Yes
Posted
1 month ago
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