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

Dane Street; United States; Remote; USD 70,000 - 110,000; Part time

Benefits offered by this job

Medical, dental, and vision coverage

Voluntary life insurance options

401k with company match

Remote workspace stipend and equipment

Paid time off

Job summary

Dane Street in Nevada is seeking an experienced CPC-certified medical coder to perform coding audits, utilization reviews, and prepare audit findings. The role includes litigation support with deposition and testimony as needed, requiring strong knowledge of medical necessity and payer policies.

Candidates must have at least 5 years of professional coding experience, Nevada-based exposure, and a track record with Medicaid billing guidelines.

Qualifications

• Active CPC certification through AAPC.
• CPMA certification preferred.
• Minimum 5 years of professional coding experience; at least 3 years in Nevada-based coding.
• Strong knowledge of Nevada Medicaid billing guidelines, fee schedules, and payer policies.
• Prior audit and utilization review experience required.
• Experience supporting legal cases, depositions, or expert testimony 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

CPC Certification

CPMA

5+ years coding

Nevada-based coding

Medical coding audits

Legal deposition support

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.
• 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, accidental 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.