Freelance Medical & Billing Coder

About the role

A new program on the group health side of our business enables you to apply your clinical knowledge to review reports accompanying medical records to ensure that medical billing information and coding are correct. You will communicate with other reviewers and their office teams to ensure clarity of information, address all questions posed, and return reports within client deadlines.

Responsibilities

• Evaluate the appropriateness of codes and determine whether they meet all established program standards.
• Ensure that medical records are matched appropriately to the codes and obtain missing records if needed.
• Read and apply policy guidelines and healthcare terminology; delineate when criteria are or are not met.
• Evaluate claims for conflict of interest and criteria appropriateness.
• Work within established timeframes set by program parameters.
• Provide strong customer service and work closely with clients on a case-by-case basis to deliver complete, timely, and error-free quality assurance of cases.
• Provide clinical oversight for complex cases requiring additional review before returning to the client.
• Serve as an additional level of QA and clinical knowledge/review for cases with quality issues.

Requirements

• Must have a CPC, APCC, CMBS, or DRG coder certification.
• Payment integrity or professional bill review experience is strongly preferred.
• Out-of-network bill review experience is a plus.
• Experience working in a remote environment is preferred.
• Experience in a medical office or healthcare background.

Skills

• Must work with a sense of urgency and meet deadlines.
• Self-motivated, with a strong drive for performance excellence.
• Excellent written and verbal communication skills.
• Proficiency in navigating a variety of computer programs (experience with Google Chrome, Gmail, Docs, Sheets, etc., is a plus).
• Strong attention to detail.

Benefits

• Robust opportunity for supplemental income.
• Schedule flexibility and predictable work hours—conduct reviews based on your availability.
• Fully prepped cases, streamlined case flow, transcription services at no cost, and a user-friendly work portal.

Dane Street is a fast-paced, Inc. 500 Company with a high-performance culture, processing 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 Exam and Peer Review programs that assist clients in reaching appropriate medical determinations as part of the claims management process.