Coder, Bill Audit Reviews

🕒 March 3

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Dane Street

WebsiteLinkedInAll Job Openings

51 - 200 employees

⚕️ Healthcare Insurance

📋 Compliance

🏛️ Government

Healthcare Insurance • Compliance • Government

Dane Street is a national leader in Independent Medical Exams and Reviews, providing objective, compliant, and timely Independent Medical Examinations, Peer Reviews, and other medical reports. With a large network of over 16,000 physicians, the company offers its services across 25,000 locations and 100 specialties, including Workers' Compensation, Auto, Liability, and Disability claims. Dane Street supports Insurance Carriers, Third Party Administrators, Managed Care Organizations, and Federal/State entities with expert medical analyses, helping them make accurate determinations. The company is recognized for its quality, fast turnaround times, and efficient processes, earning accolades like the NCQA Accreditation in Utilization Management and the Great Place to Work certification.

📋 Description

• 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

🎯 Requirements

• Active CPC certification through the American Academy of Professional Coders (AAPC) • CPMA strongly preferred • 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 • Deposition and/or expert testimony history preferred • Excellent written reporting and analytical skills • Ability to work independently and meet strict deadlines.

🏖️ Benefits

• 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.