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

About the role

Dane Street is seeking an experienced CPC certified medical coder to perform coding audits, utilization reviews, audits, and more. The ideal candidate will provide litigation support including deposition and testimony services when needed.

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

Requirements

• 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 Florida-based coding experience required
• Strong knowledge of Florida Medicaid (AHCA) billing guidelines, fee schedules, and Florida 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

Qualifications

• Florida residency is a requirement

Benefits

• Comprehensive benefits package including medical, dental, and vision coverage
• Voluntary life insurance options
• Voluntary benefits such as hospital indemnity, critical illness, accident indemnity, and pet insurance plans
• Bonus of basic life insurance, short-term disability, and long-term disability coverage
• Generous paid time off policy
• Apple equipment and a media stipend for remote workspace

About Dane Street

A fast-paced, Inc. 500 Company, Dane Street processes over 200,000 insurance claims annually for various clients including 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 to assist our clients in reaching the appropriate medical determinations as part of the claims management process.