General Coder - Must have experience doing bill audit reviews
Dane Street · US
MUST ALREADY HAVE EXPERIENCE DOING BILL AUDIT REVIEWS FOR DIFFERENT STATES. We are seeking an experienced CPC-certified medical coder with multi-state experi...
Job description
MUST ALREADY HAVE EXPERIENCE DOING BILL AUDIT REVIEWS FOR DIFFERENT STATES. We are seeking an experienced CPC-certified medical coder with multi-state experience to perform coding audits, utilization reviews, demand package reviews, and provide litigation support including deposition and testimony services as needed. The ideal candidate must have experience reviewing medical records and billing across multiple states and payer environments. Responsibilities: - Perform comprehensive medical coding audits (ICD-10-CM, CPT, HCPCS) - Conduct utilization reviews to assess medical necessity and documentation compliance - Review and prepare demand packages for personal injury and insurance cases - Analyze medical records for payer disputes, recoupments, and appeals - Prepare detailed, defensible written audit reports - Provide expert review, affidavit support, deposition preparation, and testimony when required - Interpret CMS guidelines, LCD/NCD policies, and state-specific Medicaid and commercial payer rules - Review E/M services under 2021+ guidelines - Identify compliance risks and documentation deficiencies Required Qualifications: - Active CPC certification through the American Acade...