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

Dane Street, LLC; Nevada (IA); On-site; USD 80,000 - 120,000; Full time

Benefits offered by this job

Medical coverage

Dental coverage

Vision coverage

Voluntary life insurance

Short-term disability

Long-term disability

401k with company match

Apple equipment

Media stipend for remote workspace

Paid time off

Pet insurance options

Job summary

Dane Street, LLC seeks an experienced CPC-certified medical coder to perform coding audits, utilization reviews, and related tasks in Nevada. The role supports legal deposition/testimony when needed and requires deep knowledge of medical necessity, documentation compliance, and payer audit defense.

Responsibilities include auditing ICD-10-CM, CPT, HCPCS, reviewing records for compliance, and preparing defensible audit reports. Nevada-based experience and strong documentation skills are essential.

Qualifications

• Must hold CPC certification through 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 and payer policies.
• Prior audit and utilization review experience required.
• Experience supporting legal cases, depositions or expert testimony preferred.
• Excellent written documentation and reporting skills.

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 (AAPC)

CPMA preferred

5+ years coding experience

Nevada-based coding experience

Nevada Medicaid billing knowledge

Audit & utilization review

Deposition/testimony support

Documentation & reporting

Job description

MUST RESIDE IN NEVADA 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 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.

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.