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

Dane Street; Las Vegas (NV); On-site; USD 75,000 - 110,000; Full time

Benefits offered by this job

Medical/dental/vision coverage

Voluntary life insurance

Disability coverage

Paid time off

401k with match

Remote workspace stipend

Job summary

Dane Street seeks an experienced CPC certified medical coder to perform coding audits, utilization reviews, and related tasks with a focus on Nevada-based guidelines and payer policies.

The role requires Nevada residency, strong documentation and audit skills, and the ability to provide deposition/testimony support as needed. Part-time options may be considered depending on qualifications.

Qualifications

• Active CPC certification required.
• Nevada-based coding experience required.
• Minimum 5 years of professional coding experience; 3+ years in Nevada.
• Strong knowledge of Nevada Medicaid billing guidelines and payer policies.
• Experience supporting legal cases, depositions, or expert testimony 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.

Skills

5+ years coding experience

Nevada-based coding experience

Audit and utilization review

Legal deposition/testimony experience

Education

CPC certification (AAPC)

CPMA certification preferred

Job description

• Review E/M services under 2021+ guidelines

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

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 Nevada-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 Nevada-based coding experience required
• Strong knowledge of Nevada Medicaid billing guidelines, fee schedules, and Nevada 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. Nevada 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.

• medical, dental, and vision coverage for you and your family
• voluntary life insurance options for you, your spouse, and your children
• other voluntary benefits including hospital indemnity, critical illness, accident indemnity, and pet insurance plans
• basic life insurance, short-term disability, and long-term disability coverage at no cost
• generous paid time off policy ensures you have time to relax and recharge
• 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.