Review E/M services under 2021+ guidelines
MUST RESIDE IN NEVADA AND HAVE CODING AND AUDITING EXPERIENCE. Deposition as well as Testimony experience is preferred.
Requirements
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 Nevada-based coding experience and a thorough understanding of medical necessity, documentation compliance, and payer audit defense.
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
Required Qualifications
Active CPC certification through the American Academy of Professional Coders (AAPC)
CPMA preferred
Minimum 5 years of professional coding experience
At least 3 years of Nevada-based coding experience required
Strong knowledge of Nevada Medicaid billing guidelines, fee schedules, and Nevada payer policies
Prior audit and utilization review experience required
Experience supporting legal cases, depositions, or expert testimony strongly preferred
Excellent written documentation and reporting skills
Ability to work independently and meet deadlines
This position may be part-time depending on the candidate's qualifications. Nevada residency is a requirement.
Benefits
Join our team at Dane Street and enjoy a comprehensive benefits package designed to support your well-being and peace of mind.
medical, dental, and vision coverage for you and your family
voluntary life insurance options for you, your spouse, and your children
other voluntary benefits including 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 ensures you have time to relax and recharge
401k plan with a company match helps you plan for your future
Apple equipment and a media stipend are provided for remote workspace
ABOUT DANE STREET
A fast-paced, Inc. 500 Company with a high-performance culture, is seeking insightful forward-thinking professionals. We process over 200,000 insurance claims annually for leading national and regional Workers' Compensation, Disability, Auto, and Group Health Carriers, Third-Party Administrators, Managed Care Organizations, Employers, and Pharmacy Benefit Managers. We provide customized Independent Medical Exams and Peer Review programs that assist our clients in reaching the appropriate medical determination as part of the claims management process.
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