Coder – Counter Affidavit & Auditing

🕒 Março 3

🤠 Texas – Remoto

🤠 Texas – Remote

⏱ Meio Período

🟡 Pleno

🟠 Sênior

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Dane Street

SiteLinkedInTodas as Vagas

51 - 200 funcionários

🏥 Saúde

💼 Consultoria

⚖️ Jurídico

Healthcare • Consulting • Legal

A Dane Street é líder nacional em Exames e Revisões Médicas Independentes, fornecendo Exames Médicos Independentes (IMEs), Revisões por Pares e outros laudos médicos de forma objetiva, em conformidade e dentro dos prazos. Com uma ampla rede de mais de 16. 000 médicos, a empresa oferece serviços em 25. 000 localidades e 100 especialidades, incluindo sinistros de compensação trabalhista (Workers’ Compensation), automóvel, responsabilidade civil (Liability) e incapacidade (Disability). A Dane Street atende seguradoras, Third-Party Administrators (TPAs), organizações de Managed Care e órgãos federais/estaduais com análises médicas especializadas, ajudando-os a tomar decisões precisas. A empresa é reconhecida pela qualidade, prazos de entrega ágeis e processos eficientes, tendo conquistado credenciais como a Acreditação da NCQA em Utilization Management e a certificação Great Place to Work.

Descrição

• 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

🎯 Requisitos

• 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 Texas-based coding experience required • Strong knowledge of Texas Medicaid (TMHP) and Texas commercial 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.

🏖️ Benefícios

• Join our team at Dane Street and enjoy a comprehensive benefits package designed to support your well-being and peace of mind. We offer a range of benefits including medical, dental, and vision coverage for you and your family. • Additionally, we offer voluntary life insurance options for you, your spouse, and your children. • We also offer other voluntary benefits which include hospital indemnity, critical illness, accident indemnity, and pet insurance plans. • Employees receive basic life insurance, short-term disability, and long-term disability coverage at no cost. • Our generous paid time off policy ensures you have time to relax and recharge, while our 401k plan with a company match helps you plan for your future. • Apple equipment and a media stipend are provided for remote workspace.