Certified Professional Coder
Dane Street, LLC•Houston, TX
•Remote
About The Position
We are seeking an experienced CPC-certified medical coder with multi-state experience to perform coding audits, utilization reviews, demand package reviews, and provide litigation support including deposition and testimony services as needed. The ideal candidate must have experience reviewing medical records and billing across multiple states and payer environments. This position may be structured as part time. Candidates must be comfortable reviewing policies and payer rules across multiple jurisdictions and is able to do multiple types of reviews/audits.
Requirements
- Active CPC certification through the American Academy of Professional Coders (AAPC)
- Minimum 5–7 years of professional coding experience
- Documented experience performing audits or utilization reviews in multiple states
- Strong knowledge of CMS regulations and state Medicaid variations
- Experience with Medicare, Medicare Advantage, and commercial payer audits
- Prior demand package review or litigation support experience required
- Excellent written reporting and analytical skills
- Ability to work independently and meet strict deadlines
Nice To Haves
- CPMA strongly preferred
- Deposition and/or expert testimony history preferred
- RAC, UPIC, or commercial payer audit response
- Multi-state Medicaid policy interpretation
- Expert witness experience in civil litigation
- Data analysis and audit trend reporting
Responsibilities
- Perform comprehensive medical coding audits (ICD-10-CM, CPT, HCPCS)
- Conduct utilization reviews to assess medical necessity and documentation compliance
- Review the medical portion and prepare the billing and coding review portion of demand package reviews for personal injury and insurance cases
- Analyze medical records for payer disputes, recoupments, and appeals
- Prepare detailed, defensible written audit reports
- Provide expert review, affidavit support, deposition preparation, and testimony when required
- Interpret CMS guidelines, LCD/NCD policies, and state-specific Medicaid and commercial payer rules
- Review E/M services under 2021+ guidelines
- Identify compliance risks and documentation deficiencies
Benefits
- Medical coverage
- Dental coverage
- Vision coverage
- Voluntary life insurance options
- Hospital indemnity
- Critical illness
- Accident indemnity
- Pet insurance plans
- Basic life insurance
- Short-term disability
- Long-term disability coverage
- Generous paid time off policy
- 401k plan with a company match
- Apple equipment
- Media stipend
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What This Job Offers
Job Type
Part-time
Career Level
Mid Level
Education Level
No Education Listed
