LA California Certified Coding and Billing Specialist for Litigation

Dane Street, LLC; United States; Remote; USD 90,000 - 130,000; Full time

Benefits offered by this job

Health insurance

Dental insurance

Vision insurance

Voluntary life insurance

Hospital indemnity

Critical illness coverage

Accident indemnity

Pet insurance

Paid time off

401k with match

Remote workspace stipend

Apple equipment

Job summary

Dane Street is seeking an experienced CPC certified medical coder to perform coding audits, utilization reviews, and related tasks from a California base. The role includes providing litigation support, including deposition and testimony services when required, with a focus on medical necessity, documentation compliance, and payer audits.

The ideal candidate has CA-based coding experience, strong documentation skills, and the ability to work independently to meet deadlines.

Qualifications

• CPC certification through AAPC is required.
• CPMA certification preferred.
• Minimum 5 years of professional coding experience.
• Prior audit and utilization review experience required.
• Experience supporting legal cases, depositions, or expert testimony is strongly preferred.
• Excellent written documentation and reporting skills.
• Ability to work independently and meet deadlines.

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.

Education

CPC certification through AAPC

CPMA certification preferred

5+ years professional coding experience

Prior audit and utilization review experience

Job description

Must reside in California and have litigation experience.

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 CA 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 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
• 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

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.