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

Dane Street; West Palm Beach (FL); Remote; USD 60,000 - 80,000; Part time

Benefits offered by this job

Medical, dental, and vision coverage

401k plan with company match

Generous paid time off

Short-term and long-term disability

Apple equipment for remote workspace

Job summary

A leading medical services company is seeking a CPC certified medical coder to perform audits and utilization reviews. This role requires strong Texas-based coding experience and the ability to support legal cases through expert testimony. Candidates should have at least 5 years of coding experience, excellent documentation skills, and familiarity with Texas Medicaid policies. This position may be part-time based on qualifications and is open to Texas residents only.

Qualifications

• 5+ years of professional coding experience.
• 3 years of Texas-based coding experience required.
• Prior audit and utilization review experience.

Responsibilities

• Perform detailed medical coding audits (ICD-10-CM, CPT, HCPCS).
• Conduct utilization reviews to determine medical necessity.
• Prepare audit findings and defensible reports.
• Provide expert support for depositions and testimony.

Skills

Active CPC certification

Strong Texas-based coding experience

Documentation compliance

Payer audit defense

Legal case support

Education

CPC certification

Job description

• Review E/M services under 2021+ guidelines

MUST RESIDE IN TEXAS AND HAVE CODING AND AUDITING EXPERIENCE. Counter Affidavit 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 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 recoupmentsPrepare 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.