General Coder - Must have experience doing bill audit reviews

Dane Street, LLC

4h • 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.

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
• MUST ALREADY HAVE EXPERIENCE DOING BILL AUDIT REVIEWS FOR DIFFERENT STATES.
• Candidates must be comfortable reviewing policies and payer rules across multiple jurisdictions and is able to do multiple types of reviews/audits

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 and prepare demand packages 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, dental, and vision coverage for you and your family
• voluntary life insurance options for you, your spouse, and your children
• hospital indemnity, critical illness, accident indemnity, and pet insurance plans
• basic life insurance, short-term disability, and long-term disability coverage at no cost
• generous paid time off policy
• 401k plan with a company match
• Apple equipment and a media stipend are provided for remote workspace

What This Job Offers

• Job Type: Part-time
• Career Level: Mid Level
• Education Level: No Education Listed