Coding Specialist- Holds & Denials CPC

CADUCEUSHEALTH®; United States; On-site; USD 70,000 - 90,000; Full time

Benefits offered by this job

100% remote with standard business hrs

Job summary

CADUCEUSHEALTH® is seeking a seasoned Coding Specialist to conduct high‑quality reviews and assign accurate ICD-10-CM and CPT codes for professional services. You will ensure documentation supports billing in line with medical and legal standards.

The role requires CPC certification, 5+ years of coding experience, strong knowledge of CPT/ICD-10 and Medicare rules, and meticulous, compliant work from a fully remote location during standard business hours.

Qualifications

• AAPC CPC certification required, current within the last 3 years.
• At least 5 years of professional fee coding experience.
• In-depth CPT, ICD-10, anatomy/physiology knowledge and Medicare rules.
• Excellent analytical, written and verbal communication, with strong attention to detail.
• High level of discretion with HIPAA and PHI.

Responsibilities

• Assign ICD-10-CM and CPT codes for professional services (with modifiers).
• Review documentation to support accurate coding and billing.
• Validate medical necessity based on local and national guidelines.
• Resolve coding edits/denials and assist rebilling as needed.
• Stay current with coding regulations and compliance standards.
• Meet or exceed productivity and quality benchmarks.
• Identify coding issues and contribute to process improvements.
• Participate in departmental meetings and compliance training.

Skills

CPC certification

5+ years professional fee coding

CPT & ICD-10 knowledge

Medicare rules

HIPAA/PHI discretion

Analytical & communication skills

Tools

Microsoft Office

Job description

Position: Coding Specialist coding Holds and Denials

Overview

We're seeking a seasoned Coding Specialist to conduct high-quality reviews and assign accurate codes to a wide range of patient records. Your work ensures that physician services are properly documented and billed in alignment with medical and legal standards.

What You’ll Do

• Assign ICD-10-CM and CPT codes (with modifiers) for professional fee services.
• Review documentation to support accurate coding and billing.
• Validate medical necessity based on local and national guidelines.
• Resolve coding edits, denials, and assist with rebilling when needed.
• Stay current with coding regulations and compliance standards.
• Meet or exceed productivity and quality benchmarks.
• Identify coding issues and contribute to ongoing improvements.
• Participate in departmental meetings and compliance training.

Preferred Qualifications

• AAPC CPC certification (Required) for the last 3 yrs.
• 5+ years of experience in professional fee coding.
• In-depth knowledge of CPT, ICD-10, anatomy/physiology, and Medicare rules.
• Excellent analytical, written, and verbal communication skills.
• Strong attention to detail and ability to work independently.
• High level of discretion with HIPAA and PHI.
• Proficient in Microsoft Office (Word, Excel, Outlook, Teams).
• 100% remote with standard business hours.
• Extended computer usage and sitting required.
• Ability to lift up to 30 pounds occasionally.
• Strong focus on compliance, privacy, and quality standards.

Work environment:

• A standard business environment exists with moderate noise levels.
• Ability to lift and move approximately thirty (30) pounds non-routinely.
• Ability to sit for extended periods.
• Extended periods of computer usage
• Handling – seizing, holding, grasping, and fingering of objects, tools, and controls.
• Vision – close vision
• Hearing- the ability to receive detailed information through oral and telephonic communication.