Certified Coder & Auditing (NEVADA-BASED ONLY - MUST RESIDE)

MUST RESIDE IN NEVADA AND HAVE CODING AND AUDITING EXPERIENCE. Deposition as well as Testimony experience is preferred.

Requirements

We are seeking an experienced CPC certified medical coder to perform coding audits, utilization reviews, audits and more. We are looking for someone who can provide litigation support including deposition and testimony services when needed. The ideal candidate must have strong Nevada-based coding experience and a thorough understanding of medical necessity, documentation compliance, and payer audit defense.

Responsibilities:

• Perform detailed medical coding audits (ICD-10-CM, CPT, HCPCS)
• Conduct utilization reviews to determine medical necessity and documentation compliance
• Review and prepare demand packages and audit response materials
• Analyze records for payer disputes and recoupments
• Prepare written audit findings and defensible reports
• Provide expert support for depositions and testimony as needed
• Review E/M services under 2021+ guidelines
• Interpret CMS, LCD/NCD, and payer-specific policies
• Identify risk areas and compliance vulnerabilities
• Required Qualifications: Active CPC certification through the American Academy of Professional Coders (AAPC)
• CPMA preferred
• Minimum 5 years of professional coding experience
• At least 3 years of Nevada-based coding experience required
• Strong knowledge of Nevada Medicaid billing guidelines, fee schedules, and Nevada payer policies.
• Prior audit and utilization review experience required
• Experience supporting legal cases, depositions, or expert testimony strongly preferred
• Excellent written documentation and reporting skills
• Ability to work independently and meet deadlines
• This position may be part-time depending on the candidate's qualifications. Nevada residency is a requirement.

ABOUT DANE STREET:

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