Medical & Billing Coder - Texas

Dane Street, LLC; Irving (TX); Remote; USD 50,000 - 90,000; Full time

Job summary

Join a dynamic and fast-paced company that processes over 200,000 insurance claims annually! This role is perfect for motivated bill review professionals and coders who want to apply their clinical knowledge in a meaningful way. You will play a crucial role in ensuring accurate medical billing and coding, working closely with clients to deliver high-quality service. The company offers a competitive salary, generous paid time off, and a supportive work environment that fosters growth and excellence. If you thrive in a challenging setting and are eager to make a positive impact, this opportunity is for you!

Benefits

Generous Paid Time Off

Excellent benefits package

Competitive salary

Qualifications

• CPC, APCC, or DRG coder certification required.
• Experience in payment integrity or bill review preferred.
• Strong communication and customer service skills needed.

Responsibilities

• Evaluate coding accuracy and ensure compliance with standards.
• Provide quality assurance for complex cases.
• Communicate effectively with clients and team members.

Skills

CPC coding

AAPC coding

DRG coding

Customer service skills

Attention to detail

Communication skills

Self-motivation

Education

CPC certification

APCC certification

DRG certification

Tools

Google Chrome

Gmail

Google Docs

Google Sheets

Job description

Calling all bill review professionals, CPC coders, AAPC, and DRG coders! Dane Street is looking for highly motivated Coders, bill reviewers, and payment integrity reviewers candidates to join our team. Dane Street offers an exciting work environment, competitive compensation, and strong growth potential.

Job Summary:

A new program offering on the group health side of our business enables you to apply your clinical knowledge to review reports accompanying medical records to ensure that medical billing information and coding are correct. You will communicate with other reviewers and their office teams to ensure clarity of information and ensure all questions posed have been addressed, and ensure that reports are returned within client deadlines.

Core Duties & Responsibilities:

• Evaluates the appropriateness of codes and determine whether they meet all established program standards.
• Ensures that the medical records are matched appropriately to the codes and if not, obtains them.
• Read & apply policy guidelines and healthcare terminology and delineate when criteria are/are not met.
• Evaluates claims for conflict of interest and criteria appropriateness.
• Works within established timeframes set by program parameters.
• Provides strong customer service skills and works closely with clients on a case-by-case basis to provide complete, timely, and error-free quality assurance of cases.
• Provides clinical oversight to cases that are complex and need additional review prior to return to the client.
• Serves as an additional level of QA and clinical knowledge/review for cases with quality Issues.

Required Education & Experience:

• Must have a CPC, APCC, or DRG coder certification.
• Payment integrity or professional bill review experience is strongly preferred.
• Out-of-network bill review experience is a plus.
• Experience working in a remote environment is preferred.
• Experience in a medical office or health care background.

• CPC, CCS, or CCA certification is preferred, but not required.
• Experience is a must.
• Must have access to your own billing references/engine.
• Deposition/Testimony experience is preferred, but not required.
• Extensive knowledge of Texas billing resources- for example: (FairHealth, Medicaid Texas, Texas Healthcare, etc.).
• Coding counter-audit experience is a plus.

Required Skills:

• Must work with a sense of urgency and meet deadlines.
• Must be self-motivated, with a strong drive for performance excellence.
• Excellent written and verbal communication skills are required.
• Proficiency in navigating a variety of computer programs (Experience with Google Chrome, Gmail, Docs, Sheets, etc., is a plus).
• Attention to detail REQUIRED.

PLEASE BE AWARE: In the interest of the security of both parties, please be aware that Dane Street will never conduct an interview via text or request checks from candidates for purchasing equipment.

We offer generous Paid Time Off, an excellent benefits package, and a competitive salary. If you are an outstanding candidate for this position, if you thrive in a fast-paced environment, and if you are interested in doing meaningful work that impacts others' lives, then we encourage you to apply!

ABOUT DANE STREET:

A fast-paced, Inc. 500 Company with a high-performance culture, Dane Street is seeking insightful, astute 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 Exam and Peer Review programs that assist our clients in reaching the appropriate medical determination as part of the claims management process.