Front-End Coding Specialist: Claims Accuracy

CADUCEUSHEALTH®; United States; On-site; USD 45,000 - 65,000; Full time

Job summary

CADUCEUSHEALTH® is seeking a Coding Specialist I to review, analyze, and resolve front-end claims for accurate submission. This role focuses on identifying coding issues before transmission and applying established guidelines and payer requirements.

You will collaborate with revenue cycle partners to prevent rejections, maintain high coding accuracy, and stay current with HIPAA rules while working in a fast-paced environment.

Qualifications

• Current AAPC or AHIMA certification with at least 3 years of professional coding experience.
• Strong CPT and ICD-10-CM knowledge and Medicare reimbursement guidelines.
• Excellent written and verbal communication and ability to work independently.
• Experience in medical billing and HIPAA compliance.

Responsibilities

• Review front-end claims to determine codes before transmission.
• Maintain at least 90% coding accuracy.
• Assign ICD-10-CM and CPT codes with modifiers for professional services.
• Ensure documentation meets medical necessity guidelines.
• Resolve front-end claim holds and escalate trends as needed.
• Adhere to HIPAA and protect patient information.
• Participate in team meetings and mentorship sessions.

Skills

AAPC/AHIMA cert

CPT coding

ICD-10-CM

Medical terminology

Anatomy & physiology

Medicare guidelines

HIPAA compliance

Microsoft Office

Tools

Microsoft Office Suite

Job description

CADUCEUSHEALTH® is seeking a Coding Specialist I to review, analyze, and resolve front-end claims for accurate submission. This role focuses on identifying coding issues before transmission and applying established guidelines and payer requirements.

You will collaborate with revenue cycle partners to prevent rejections, maintain high coding accuracy, and stay current with HIPAA rules while working in a fast-paced environment.