Remote Forensic Medical Billing & Coding Analyst

Jsheldllc

Jericho (NY)

On-site

USD 100,000 - 110,000

Full time

6 days ago

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Job summary

Jsheldllc seeks a Forensic Medical Coding & Billing Specialist to join our Medical Records and Billing team. You will review records and bills to identify inaccuracies, prepare reports, and support potential legal proceedings.

The role requires CPT/ICD/HCPCS expertise, EHR/billing software proficiency, and the ability to testify as an expert witness. Remote work option is available; strong attention to detail and regulatory knowledge are essential.

Qualifications

Bachelor's degree in Medical Coding or related field.
Certification in Medical Coding such as CPC or CCS; other certifications like BCSC, CPMA or CMRS are a plus.
Higher level coding and billing certifications.
Minimum of 5 years of experience in medical billing and coding, with forensic analysis focus.
Deep understanding of healthcare billing processes, insurance claims, and regulatory guidelines.
Exceptional attention to detail and analytical skills.

Responsibilities

Forensic review of medical records, bills, and documents to identify inaccuracies or fraud.
Evaluate CPT, ICD, HCPCS, and other coding systems to pinpoint discrepancies.
Navigate EHR systems and billing software; assist with audits of billing and documentation.
Serve as an expert witness in legal proceedings with clear testimony on coding and billing matters.
Prepare reports detailing discrepancies, overcharges, or suspected fraud for legal use.
Collaborate with legal and compliance teams to provide evidence and data-backed insights.