LA California Certified Coding and Billing Specialist for Litigation

Must reside in California and have litigation experience.

Must reside in California and have litigation experience.

We are seeking an experienced CPC certified medical coder to perform coding audits, utilization reviews, audits and more. We are looking for someone who can provide litigation support including deposition and testimony services when needed. The ideal candidate must have strong CA based coding experience and a thorough understanding of medical necessity, documentation compliance, and payer audit defense. Counter Affidavit experience is preferred.

Responsibilities:

• Perform detailed medical coding audits (ICD-10-CM, CPT, HCPCS)

• Conduct utilization reviews to determine medical necessity and documentation compliance

• Review and prepare demand packages and audit response materials

• Analyze records for payer disputes and recoupments

• Prepare written audit findings and defensible reports

• Provide expert support for depositions and testimony as needed

• Review E/M services under 2021+ guidelines

• Interpret CMS, LCD/NCD, and payer-specific policies

• Identify risk areas and compliance vulnerabilities

Required Qualifications:

• Active CPC certification through the American Academy of Professional Coders (AAPC)

• CPMA preferred

• Minimum 5 years of professional coding experience

• Prior audit and utilization review experience required

• Experience supporting legal cases, depositions, or expert testimony strongly preferred

• Excellent written documentation and reporting skills

• Ability to work independently and meet deadlines