Certified Coder & Auditing (FLORIDA-BASED ONLY - MUST RESIDE)

Dane Street; Washington (District of Columbia); On-site; USD 80,000 - 110,000; Full time

Benefits offered by this job

Medical, dental, and vision coverage

Voluntary life insurance

Short-term and long-term disability

401k with company match

Remote workspace stipend

Paid time off

Job summary

Dane Street is seeking an experienced CPC-certified medical coder to perform coding audits, utilization reviews, and related tasks. The ideal candidate will have strong Florida-based coding experience and knowledge of medical necessity and payer audits.

Responsibilities include supporting legal cases with deposition and testimony when needed, and reviewing E/M services under 2021+ guidelines, while aligning with CMS, LCD/NCD, and payer policies.

Qualifications

• Active CPC certification through AAPC is required.
• Minimum 5 years of professional coding experience.
• At least 3 years of Florida-based coding experience required.
• Strong knowledge of Florida Medicaid billing guidelines and payer policies.
• Prior audit and utilization review experience required.

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.

Skills

CPC certification

Florida-based coding experience

Auditing experience

Deposition/testimony experience

Florida Medicaid knowledge

Education

CPC certification (AAPC)

CPMA preferred

Tools

ICD-10-CM

CPT

HCPCS

Florida AHCA guidelines

Job description

Requirements

• Review E/M services under 2021+ guidelines

MUST RESIDE IN FLORIDA AND HAVE CODING AND AUDITING EXPERIENCE. Deposition as well as Testimony experience is preferred.

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 Florida-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 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
• 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. Florida 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.