Healthcare Coding & Consulting Services (HCCS) is seeking an experienced Pro Clinic Coding Denial Specialist to join our growing team. This is a fully remote, full-time opportunity for a coding professional with strong experience resolving coding-related denials and a solid understanding of medical billing and the healthcare revenue cycle.
This position will support orthopedic denial management and appeals. We are seeking an experienced professional fee (Pro Clinic) coding specialist with extensive denial management experience and a strong understanding of medical billing and the healthcare revenue cycle. The ideal candidate has advanced knowledge of CPT, ICD-10-CM, HCPCS, modifiers, payer guidelines, and reimbursement methodologies, and can identify, research, and resolve complex coding-related denials while preparing effective appeals to maximize reimbursement.
Position Requirements
- AAPC and/or AHIMA certification required; CPC, CCS, CPMA, CPB certifications preferred.
- Minimum of three (3) years of Pro Clinic (Outpatient E/M) experience.
- Minimum of three (3) years of experience working 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 required.
- Experience reviewing medical records, claims, EOBs, remittance advice, and payer correspondence to identify coding and billing discrepancies.
- 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.
Why Join HCCS?
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.
Work Location: Remote
