Experienced CPC-Certified Medical Coder
MUST ALREADY HAVE EXPERIENCE DOING BILL AUDIT REVIEWS FOR DIFFERENT STATES.
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.
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