Certified Coding and Billing Specialist – Litigation

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

📋 Description

• Conduct thorough medical coding audits utilizing ICD-10-CM, CPT, and HCPCS codes.

• Carry out utilization reviews to assess medical necessity and ensure compliance with documentation standards.

• Review and compile demand packages along with audit response documentation.

• Analyze records pertaining to payer disputes and recoupment processes.

• Generate written reports detailing audit findings and defensible conclusions.

• Offer expert support for depositions and testimony as required.

• Evaluate E/M services according to the 2021+ guidelines.

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

• Identify areas of risk and potential compliance vulnerabilities.

• Provide litigation support, including deposition and testimony services when necessary.

• Assist Dane Street’s claims management services for workers’ compensation, disability, auto, and group health carriers, along with associated organizations.

⛳️ Requirements

• Must be a resident of California.

• Experience in litigation is required.

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

• At least 5 years of professional coding experience is necessary.

• Previous experience in auditing and conducting utilization reviews is essential.

• Strong coding background specific to California is required.

• Comprehensive understanding of medical necessity, documentation compliance, and payer audit defense is crucial.

• Excellent skills in written documentation and reporting are expected.

• Capability to work independently and adhere to deadlines is essential.

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

• CPMA certification is preferred.

• Experience with Counter Affidavit is preferred.

🏝️ Benefits

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

• Voluntary life insurance options for employees, their 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 offered 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 workspaces.

• Media stipend available for remote workspaces.