Dane Street
Dane Street
Dane Street nodrošina neatkarīgas medicīniskās pārbaudes, kolēģu ekspertīzes un ar tām saistītus medicīniskās ziņošanas pakalpojumus, lai pieņemtu lēmumus par atlīdzību prasībām un ārstēšanas nepieciešamību. Uzņēmums darbojas veselības aprūpes, konsultāciju un juridiskajā jomā, savienojot apdrošinātājus, trešo pušu administratorus, pārvaldītās aprūpes organizācijas un valsts iestādes ar vairāk nekā 16 000 ārstu tīklu, kas aptver 100 specialitātes un 25 000 atrašanās vietu. Tā darbs atbalsta darbinieku kompensāciju, autoavāriju, civiltiesiskās atbildības un invaliditātes prasību izskatīšanu, izmantojot savlaicīgu, prasībām atbilstošu un objektīvu medicīnisko analīzi.

Certified Medical Coding and Billing Specialist - Litigation (California Remote)

Audit medical coding and claims while supporting litigation matters for Dane Street. Review utilization, compliance, payer disputes, depositions, and expert testimony.

Apraksts

  • Audit medical records using ICD-10-CM, CPT, and HCPCS coding standards
  • Conduct utilization reviews focused on medical necessity and documentation compliance
  • Review and assemble demand packages and audit response documentation
  • Evaluate records for payer disputes and recoupment issues
  • Draft clear, defensible audit findings and reports
  • Provide expert assistance for depositions and testimony when required
  • Review evaluation and management services under guidelines effective from 2021 onward
  • Apply CMS, LCD/NCD, and payer-specific policies in audit work
  • Flag compliance vulnerabilities and other areas of risk
  • Support litigation matters through deposition and testimony services when needed
  • Contribute to Dane Street claims-management services for workers’ compensation, disability, auto, and group health carriers and related organizations

Prasības

  • Live in California
  • Bring experience handling litigation matters
  • Hold an active CPC certification from the American Academy of Professional Coders (AAPC)
  • Have at least five years of professional medical coding experience
  • Have previous experience with audits and utilization reviews
  • Demonstrate strong experience with California-based coding
  • Understand medical necessity, documentation compliance, and payer audit defense thoroughly
  • Produce clear, accurate written documentation and reports
  • Work independently while consistently meeting deadlines
  • Experience with legal cases, depositions, or expert testimony is strongly preferred
  • CPMA certification is preferred
  • Counter Affidavit experience is preferred

Priekšrocības

  • Medical, dental, and vision coverage for employees and eligible family members
  • Voluntary life insurance for employees, spouses, and children
  • Voluntary hospital indemnity, critical illness, accident indemnity, and pet insurance options
  • Employer-paid basic life insurance
  • Employer-paid short-term disability coverage
  • Employer-paid long-term disability coverage
  • Generous paid time off
  • 401(k) plan with company matching
  • Apple equipment for the remote workspace
  • Media stipend for the remote workspace

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