Medical Coding Auditor & Quality Specialist

Job Description

Lakeshore Talent is in search of a Code Review Specialist – Medical Coding Methodology & Litigation Support

Location: Greenwood Village, CO (Denver Tech Center)

Position Type: Direct Hire

Salary: $75,000–$85,000 annually

Schedule: Monday–Friday, with Wednesdays remote and the remaining days in the office

Start Time: 7:00 AM or 8:00 AM

Position Overview

Lakeshore Talent is in search of a detail-oriented Code Review Specialist to join a growing team specializing in medical coding methodology, billing review, and litigation support. This role is ideal for an experienced medical coding professional who enjoys analytical work, takes pride in accuracy, and is interested in improving processes rather than simply following established procedures.

In this position, you will review medical records and billing documentation, validate CPT and HCPCS procedure codes and modifiers, and ensure that coding decisions are accurate, consistent, and well-documented. Your work will support the development of transparent, defensible medical damage valuations used in litigation-related cases.

Beyond day-to-day code review, you will play an important role in refining coding methodologies, improving workflows, developing training resources, and establishing clear guidelines that help the team work more efficiently. You will also serve as a knowledgeable resource for expert witnesses, attorneys, paralegals, and internal teams, helping them understand the review process and the rationale behind coding decisions.

This is an excellent opportunity for someone who combines strong technical coding knowledge with critical thinking, communication, and a process-improvement mindset.

Key Responsibilities

Medical Coding Review

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• Organize medical records and billing documentation into a clear, logical structure that supports efficient and thorough review.
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• Compare captured billing information against medical records to validate CPT and HCPCS procedure codes and modifiers, making corrections when supported by the documentation.
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• Evaluate procedures across applicable billing components, including professional services, facility charges, anesthesia, and other related services.
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• Apply established coding review methodologies consistently and document the rationale behind decisions to ensure transparency and reproducibility.
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• Identify missing, conflicting, or ambiguous documentation and address discrepancies according to established review guidelines rather than assumptions.
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• Manage multiple cases and review assignments while meeting established deadlines and maintaining quality standards.
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Methodology Development & Process Improvement

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• Identify inefficiencies, recurring questions, inconsistencies, and potential errors within existing coding methodologies and workflows.
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• Recommend practical improvements to clarify coding rules, simplify processes, and improve review accuracy and efficiency.
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• Implement approved changes by updating procedures, documentation, reference materials, decision rules, and examples.
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• Develop and contribute to training materials, worked examples, quality checks, and job aids to support consistent reviews and streamline onboarding.
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• Use feedback and recurring questions from colleagues, expert witnesses, and clients to identify opportunities to improve methodology documentation.
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• Collaborate with team members to create scalable processes that support future growth.
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Expert Witness & Client Support

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• Serve as a knowledgeable resource for expert witnesses regarding coding review procedures, methodology, and supporting documentation.
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• Respond to questions clearly, accurately, and professionally, providing transparent explanations of the review process.
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• Build strong working relationships with expert witnesses through dependable work, timely communication, and consistent attention to detail.
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• Respond to attorney and paralegal questions regarding the coding review process and the scope of the company's audit services.
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• Clearly explain coding concepts and procedures to audiences with varying levels of technical knowledge, including legal professionals.
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• Support expert witnesses in understanding the review methodology while respecting their independent review processes and professional opinions.
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Case Coordination & Cross-Functional Collaboration

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• Develop an understanding of the full case lifecycle, from medical record intake and bill capture through valuation and reporting.
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• Partner closely with Case Managers before and after the coding review process to identify incoming data issues and ensure completed reviews are ready for valuation.
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• Consider the impact of proposed process changes on upstream and downstream workflows.
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• Serve as a trusted coding resource for Case Managers and other internal teams.
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• Contribute to a collaborative environment focused on accuracy, continuous improvement, and effective case management.
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Qualifications & Requirements

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• Bachelor's degree or an equivalent combination of education and certified coding experience.
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• At least 3 years of hands-on, credentialed medical coding experience, including professional procedure coding.
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• Current coding certification, such as CPC, CCS, CCS-P, COC, or an equivalent credential.
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• Working knowledge of medical documentation and coding related to orthopedics, pain management, physical therapy, and neurology.
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• Strong understanding of CPT and HCPCS coding guidelines and conventions, including modifiers.
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• Foundational understanding of how medical procedures are billed across professional, facility, anesthesia, and other applicable components.
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• Ability to explain coding processes clearly, both verbally and in writing, to technical and nontechnical audiences.
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• Intermediate Microsoft Excel skills.
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• Strong analytical skills and exceptional attention to detail.
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• A process-improvement mindset, including the ability to recognize inefficiencies, identify the root causes of problems, and recommend practical solutions.
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• Comfort receiving constructive feedback and providing candid, professional feedback to improve workflows and outcomes.
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• Ability to manage competing priorities and meet deadlines in a detail-intensive environment.
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Preferred Qualifications

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• Certified Professional Medical Auditor (CPMA) or another auditing credential.
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• Specialty coding certifications, such as COSC (orthopedics) or CANPC (anesthesia).
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• Experience conducting coding audits, quality reviews, or other structured review processes.
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• Experience developing or contributing to coding policies, audit procedures, training materials, reference guides, or job aids.
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• Experience improving standardized processes or documenting complex procedures for team-wide use.
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Compensation & Benefits

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• Annual salary of $75,000–$85,000, depending on qualifications and experience.
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• Medical, dental, and vision insurance.
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• 401(k) with company match.
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• Monthly cell phone contribution of $75.
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• Generous vacation policy, starting at 15 days per year.
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• Company-paid holidays.
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• Work-from-home Wednesdays.
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• Summer Friday office hours.
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• Company-provided parking garage pass.
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Culture & Work Environment

The organization values humility, honor, positivity, engagement, and innovation. These values guide daily decision-making, collaboration, and how team members support one another.

The team fosters a collaborative, supportive environment where employees are encouraged to share ideas, help colleagues, and take ownership of meaningful work. Continuous improvement is an important part of the culture, and team members have the opportunity to contribute ideas that strengthen both individual performance and overall operations.

Why This Opportunity?

This role offers more than traditional medical coding work. It provides the opportunity to apply your coding expertise in a specialized environment that combines medical billing review, analytical problem-solving, and litigation support.

You will have a meaningful voice in shaping coding methodologies, improving processes, and developing resources that help the entire team succeed. If you enjoy technical coding work, value accuracy and consistency, and are motivated by making complex processes clearer and more effective, this could be an excellent next step in your career.

Interested candidates are encouraged to apply!