Certified Coder, Auditing

🔥 0 minutes ago

🐊 Florida – Remote

🐊 Florida – Remote

⏱ Part Time

🟡 Mid-level

🟠 Senior

👻 Ghost score 25%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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Dane Street

WebsiteLinkedInAll Job Openings

51 - 200 employees

🏥 Healthcare

💼 Consulting

⚖️ Legal

Healthcare • Consulting • Legal

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 detailed medical coding audits using ICD-10-CM, CPT, and 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 • Provide litigation support, including deposition and testimony services when needed • Process and support independent medical examinations and peer review programs for insurance claims management

🎯 Requirements

• Must reside in Florida • Active CPC certification through the American Academy of Professional Coders (AAPC) • Minimum 5 years of professional coding experience • At least 3 years of Florida-based coding experience required • Strong knowledge of Florida Medicaid (AHCA) billing guidelines, fee schedules, and Florida payer policies • Prior audit and utilization review experience required • CPMA preferred • Experience supporting legal cases, depositions, or expert testimony strongly preferred • Excellent written documentation and reporting skills • Ability to work independently and meet deadlines • Strong understanding of medical necessity, documentation compliance, and payer audit defense • Coding experience with ICD-10-CM, CPT, and HCPCS • Knowledge of 2021+ E/M guidelines • Ability to interpret CMS, LCD/NCD, and payer-specific policies

🏖️ Benefits

• Medical, dental, and vision coverage for employees and families • Voluntary life insurance for employees, spouses, and children • Voluntary hospital indemnity, critical illness, accident indemnity, and pet insurance plans • Basic life insurance at no cost • Short-term disability coverage at no cost • Long-term disability coverage at no cost • Generous paid time off • 401(k) plan with company match • Apple equipment for remote workspace • Media stipend for remote workspace