Remote CPC Medical Coder — Multi-State Audits & Litigation

Dane Street, LLC; Houston (TX); On-site; USD 85,000 - 115,000; Full time

Benefits offered by this job

Medical Insurance

Dental Insurance

Vision Insurance

401(k) with company match

Paid time off

Remote workspace stipend

Voluntary life insurance

Job summary

Dane Street is seeking an experienced CPC-certified medical coder with multi-state experience to perform coding audits, utilization reviews, and demand package reviews for personal injury and insurance cases. The role includes building defensible audit reports and providing deposition support as needed.

The ideal candidate will review records across various payer environments, interpret CMS guidelines, and identify compliance risks while meeting strict deadlines.

Qualifications

• Active CPC certification through AAPC.
• Minimum 5–7 years of professional coding experience.
• Documented experience performing audits or utilization reviews in multiple states.
• Strong knowledge of CMS regulations and state Medicaid variations.
• Experience with Medicare, Medicare Advantage, and commercial payer audits.
• Prior demand package review or litigation support experience required.
• Deposition and/or expert testimony history preferred.

Responsibilities

• Perform comprehensive medical coding audits (ICD-10-CM, CPT, HCPCS).
• Conduct utilization reviews to assess medical necessity and documentation compliance.
• Review the medical portion and prepare the billing and coding review portion of demand package reviews for personal injury and insurance cases.
• Analyze medical records for payer disputes, recoupments, and appeals.
• Prepare detailed, defensible written audit reports.
• Provide expert review, affidavit support, deposition preparation, and testimony when required.
• Interpret CMS guidelines, LCD/NCD policies, and state-specific Medicaid and commercial payer rules.
• Review E/M services under 2021+ guidelines.
• Identify compliance risks and documentation deficiencies.

Skills

CPC Certification

Multi-state Audits

CMS Regulations

Deposition/Testimony

Audit & Utilization Reviews

Reporting & Analysis

Independent Worker

Job description

Dane Street is seeking an experienced CPC-certified medical coder with multi-state experience to perform coding audits, utilization reviews, and demand package reviews for personal injury and insurance cases. The role includes building defensible audit reports and providing deposition support as needed.

The ideal candidate will review records across various payer environments, interpret CMS guidelines, and identify compliance risks while meeting strict deadlines.