Medical & Billing Coder

Responsibilities

• Evaluate the appropriateness of codes to ensure they meet established program standards
• Match medical records to codes and obtain necessary documentation when discrepancies arise
• Apply policy guidelines and healthcare terminology to determine if criteria are met
• Evaluate claims for conflict of interest and criteria appropriateness
• Work within established timeframes and client deadlines
• Provide clinical oversight for complex cases and serve as an additional level of quality assurance
• Communicate with reviewers and office teams to ensure clarity and resolve questions

Requirements

• Must have CPC, APCC, CMBS, or DRG coder certification
• Experience in a medical office or healthcare background
• Proficiency in navigating computer programs, specifically Google Workspace (Gmail, Docs, Sheets)
• Strong attention to detail and excellent written and verbal communication skills
• Ability to work with a sense of urgency and meet strict deadlines

Preferred Qualifications

• Experience in payment integrity or professional bill review
• Out-of-network bill review experience
• Experience working in a remote environment

Benefits

• Robust opportunity for supplemental income
• Schedule flexibility with predictable work hours based on your availability
• Streamlined case flow with fully prepped cases and free transcription services
• User-friendly work portal

About the Company

Dane Street is an Inc. 500 company that processes over 200,000 insurance claims annually for leading national and regional carriers, TPAs, and employers. We provide customized Independent Medical Exam and Peer Review programs to assist clients in reaching appropriate medical determinations.