Dane Street is a Boston, Massachusetts-based independent medical examination (IME) and peer-review organization that provides credible, objective exams and revi
Certified Coder & Auditing (TEXAS BASED ONLY - MUST RESIDE)
Location
United States
Posted
13 days ago
Salary
Not specified
Job Description
MUST RESIDE IN TEXAS AND HAVE CODING AND AUDITING EXPERIENCE. Counter Affidavit as well as Testimony experience is preferred.
Job 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 Texas based coding experience and a thorough understanding of medical necessity, documentation compliance, and payer audit defense. Counter Affidavit experience is preferred.
- 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 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
- This position may be part-time depending on the candidate's qualifications. Texas 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. 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.
- 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.
Related Guides
Related Categories
Related Job Pages
More Medical Billing and Coding Jobs
Scheduling Coordinator
Mortgage ConnectMortgage Connect is a national mortgage service provider specializing in assisting mortgage lenders with a multitude of services they need in connection with a loan. Our entrepreneurial mindset allows us to differentiate ourselves in the market through continuous improvement and innovation, as well as our diversified suite of product offerings. Our people are driven and committed to our cultural values we call “The 5C’s”: Connect, Collaborate, Communicate, Care, and Celebrate. All onboarding employees will be required to complete a pre-employment background check and drug screening. We are an Equal Opportunity employer committed to diversity in the workplace.
We are in the business of loan modifications and are looking for a Scheduling Coordinator who will find a career home with us. This non-exempt role is for someone who loves working with details in a fast-paced and team-centered environment as you will be responsible for collabora...
We are looking for an assertive and driven clinical professional to join our team in a crucial administrative role to help our ABA Therapy organization grow! Support the Vice President of Clinical Services, the Director of Clinical Advocacy and Authorizations, and the Regional Au...
Risk Coder
Community Care CooperativeCommunity Care Cooperative (C3) is a 501(c)(3) non-profit, Accountable Care Organization (ACO) governed by Federally Quality Health Centers (FQHCs). Our mission is to leverage the collective strengths of FQHCs to improve the health and wellness of the people we serve. We are a fast-growing organization founded in 2016 with 9 health centers and now serving hundreds of thousands of beneficiaries who receive primary care at health centers and independent practices across Massachusetts. We are an innovative organization developing new partnerships and programs to improve the health of members and communities, and to strengthen our health center partners.
The Certified Risk Coder will be a part of an emerging coding team and coding service that performs retrospective and prospective risk coding reviews and completes provider training for a group of outpatient primary care practices across Massachusetts. This work ultimately leads ...
Pro Fee Coder – General Pediatrics
SavistaAn end-to-end revenue cycle services provider serving healthcare organizations for over 30 years.
Pro Fee Coder reviewing clinical documentation for healthcare billing
