[Hiring] Medical Reimbursement Coding Specialist @Dane Street, LLC

Role Description

We are seeking a highly skilled, hands-on Medical Reimbursement coding specialist to join our day-to-day bill review operations while actively participating in complex case reviews and serving as a key resource for our legal services division. You will maintain a production workload focused on high-dollar, complex medical bill review/legal cases.

• Leverage an intimate knowledge of major medical bill review software and national repricing/payer systems.
• Ensure absolute accuracy in identifying excessive or unsupported charges, determining reasonable reimbursement amounts, and defending those findings in litigation.
• Serve as a Subject Matter Expert (SME) and Expert Witness for legal proceedings, providing forensic billing analyses, affidavits, and deposition/trial testimony.
• Texas-specific expertise is preferred in billing regulations, workers' compensation guidelines, and Usual, Customary for other states, and Reasonable (UCR) fee structures.

Qualifications

• Business experience in a healthcare and/or insurance setting is preferred.
• Good communication skills with a clear understanding of company business lines.
• Ability to apply critical thinking, manage time efficiently, and meet specific deadlines.
• 2–4+ years of experience in customer service, account management, customer success, insurance operations, healthcare operations, or another client-facing operational environment.
• Exceptional written and verbal communication skills.

Requirements

• Active industry certification is strictly required (e.g., CPC, CCS).
• Exceptional written and verbal communication, professional judgment, discretion, relationship-building, and conflict-resolution skills.
• Strong critical thinking and independent case assessment; ability to interpret complex instructions, recognize risks, and determine appropriate escalation.
• Excellent organization, prioritization, time management, and follow-through across high-volume, deadline-driven work.
• Working knowledge of clinical and legal review workflows, expert credentials, report quality expectations, and company service lines.
• Ability to coordinate across clients, physicians, attorneys, adjusters, Sales, Operations, Management, and Finance.
• Computer literacy, typing proficiency, and ability to learn and maintain accurate records in company systems.
• Extensive, hands-on experience in Medical Bill Review.
• Proven, documented experience providing legal services, expert witness reports, or trial testimony regarding medical bill reasonableness and UCR value analysis.
• Technical Expertise: Advanced proficiency in major industry-standard bill review platforms (e.g., Conduent/StrataCare, Mitchell/Enlyte, Medata, CompIQ or similar).
• Based in Texas (highly preferred) or possessing extensive experience testifying specifically within the Texas court system and applying Texas statutory fee schedules.

Benefits

• Collaborative remote culture.
• Professional growth opportunities.
• Meaningful work supporting the healthcare industry.
• Comprehensive benefits.
• Great Place to Work Certified since 2021.
• Commitment to employee development.
• Medical, dental, and vision coverage for you and your family.
• Voluntary life insurance options for you, your spouse, and your children.
• Other voluntary benefits including hospital indemnity, critical illness, accident indemnity, and pet insurance plans.
• Basic life insurance, short-term disability, and long-term disability coverage at no cost.
• Generous paid time off policy.
• 401k plan with a company match.
• Apple equipment and a media stipend for remote workspace.

Company Description

A fast-paced, Inc. 500 Company with a high-performance culture, is seeking insightful forward-thinking professionals. We process 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 Exams and Peer Review programs that assist our clients in reaching the appropriate medical determination as part of the claims management process.