Medical-Denial Management Specialist

Orthopedic Assoc of Hartford P • Farmington, CT

9d • Hybrid

About The Position

Orthopedic Associates of Hartford, P.C., an orthopedic practice established in 1970, is seeking a Medical-Denial Management Specialist with Epic experience to join its Billing & Collections team at its business office in Farmington, Connecticut. This hybrid position requires regular onsite attendance, and candidates should live within commuting distance of the office.

The specialist analyzes and resolves healthcare insurance claim denials by investigating their causes, preparing appeals, communicating with payers, and collaborating with billing staff. The role supports proper reimbursement and prevention of future denials. It requires analytical, communication, and problem-solving skills, as well as knowledge of insurance policies, medical terminology, healthcare billing procedures, and insurance payment methodologies. The successful candidate is dependable, organized, enthusiastic, detail-oriented, and able to build relationships with internal and external customers to promote feedback and timely resolution of outstanding claims. Proficiency with multiple computer software programs and a positive, can-do attitude are also required.

Requirements

• Two years of recent experience in medical collections and/or medical billing, with results-oriented debt-collection skills.
• Familiarity with ICD-10 coding and federal HIPAA regulations.
• Computer skills, including Epic, electronic billing, Microsoft Word, Outlook, and Excel.
• Excellent written and verbal communication skills and a professional, courteous telephone manner.
• High school diploma.
• Strong analytical, communication, and problem-solving skills.
• Thorough understanding of insurance policies, medical terminology, healthcare billing procedures, and insurance payment methodologies.
• Dependable, organized, enthusiastic, and detail-oriented; able to build relationships with internal and external customers.
• Proficiency with multiple computer software programs and a positive, can-do attitude.

Responsibilities

• Follow policies and procedures to perform timely and accurate follow-up on claims and resolve outstanding balances.
• Participate in collecting and documenting claims-processing rules.
• Generate electronic and hard-copy claims for submission.
• Obtain supporting documentation and other information needed to ensure claim acceptance.
• Communicate effectively with interdepartmental units when necessary.
• Document account information related to claim submission and resolution.
• Enter demographic data into billing and collections software.
• Assume other duties and responsibilities as needed.

What This Job Offers

• Job Type: Full-time
• Education Level: High school or GED