Certified Coder, Auditing

This is a fully remote position, open to applicants in Nevada.

📋 Description

• Execute comprehensive medical coding audits utilizing ICD-10-CM, CPT, and HCPCS.

• Carry out utilization reviews to assess medical necessity and adherence to documentation standards.

• Examine and assemble demand packages along with materials for audit responses.

• Evaluate records related to payer disputes and recoupments.

• Compile written audit conclusions and defensible reports.

• Offer litigation support, which includes deposition and testimony services as required.

• Review E/M services in accordance with 2021+ guidelines.

• Interpret CMS, LCD/NCD, and specific payer policies.

• Identify areas of risk and compliance weaknesses.

• Operate independently while adhering to deadlines.

⛳️ Requirements

• Candidate must reside in Nevada.

• Active CPC certification from the American Academy of Professional Coders (AAPC) is required.

• A minimum of 5 years of professional coding experience is necessary.

• At least 3 years of coding experience specifically in Nevada is required.

• Strong understanding of Nevada Medicaid billing guidelines, fee schedules, and payer policies is essential.

• Prior experience in audit and utilization review is mandatory.

• In-depth knowledge of medical necessity, documentation compliance, and payer audit defense is crucial.

• CPMA certification is preferred.

• Experience in supporting legal cases, depositions, or expert testimony is highly preferred.

• Excellent skills in written documentation and reporting are necessary.

• Ability to work independently and meet deadlines is required.

• Proficiency in coding with ICD-10-CM, CPT, and HCPCS is essential.

• Familiarity with 2021+ E/M guidelines is important.

• Capable of interpreting CMS, LCD/NCD, and payer-specific policies.

🏝️ Benefits

• Medical, dental, and vision insurance coverage for employees and their families.

• Voluntary life insurance available for employees, spouses, and children.

• Optional hospital indemnity, critical illness, accident indemnity, and pet insurance plans.

• Basic life insurance provided at no cost.

• Short-term disability coverage available at no cost.

• Long-term disability coverage provided at no cost.

• Generous paid time off policy.

• 401k plan with company matching contributions.

• Apple equipment provided for remote work setups.

• Media stipend offered for remote workspace expenses.