Certified Coder & Auditing (FLORIDA-BASED ONLY - MUST RESIDE)

Dane Street, LLC•West Palm Beach, FL

3d•Remote

About The Position

We are seeking an experienced CPC certified medical coder to perform coding audits, utilization reviews, audits and more. We are looking for someone who can provide litigation support including deposition and testimony services when needed. The ideal candidate must have strong Florida-based coding experience and a thorough understanding of medical necessity, documentation compliance, and payer audit defense.

Requirements

Active CPC certification through the American Academy of Professional Coders (AAPC)
Minimum 5 years of professional coding experience
At least 3 years of Florida-based coding experience required
Strong knowledge of Florida Medicaid (AHCA) billing guidelines, fee schedules, and Florida payer policies.
Prior audit and utilization review experience required
Excellent written documentation and reporting skills
Ability to work independently and meet deadlines
Must reside in Florida

Nice To Haves

CPMA preferred
Deposition as well as Testimony experience is preferred
Experience supporting legal cases, depositions, or expert testimony strongly preferred

Responsibilities

Perform detailed medical coding audits (ICD-10-CM, CPT, HCPCS)
Conduct utilization reviews to determine medical necessity and documentation compliance
Review and prepare demand packages and audit response materials
Analyze records for payer disputes and recoupments
Prepare written audit findings and defensible reports
Provide expert support for depositions and testimony as needed
Review E/M services under 2021+ guidelines
Interpret CMS, LCD/NCD, and payer-specific policies
Identify risk areas and compliance vulnerabilities