Operations & Production Leadership (Working Supervisor)
● Team Management: Supervise, mentor, and audit the performance of expert bill review
staff and contract experts to ensure accuracy, productivity, and adherence to turnaround
● Hands-on Review: Function as a "working" supervisor by directly reviewing complex,
high-dollar, or disputed medical bills (e.g., trauma, inpatient stays, etc).
● Quality Assurance: Conduct regular quality control audits on team output, identifying
training gaps and updating standard operating procedures (SOPs).
Software & Payer System Repricing Optimization
● System Mastery: Act as the internal administrator/expert for our Medical Bill Review
software, optimizing workflows, auto-adjudication rules, and engine logic specific to
Dane Street and Client preferences and requirements.
● National Repricing/Payer Systems: Apply comprehensive knowledge of national
repricing mechanisms and payer guidelines to maximize accuracy and identify
erroneous billing/overbilling.
● Reimbursement Integrity: Ensure correct application of fee schedules, line-item audits,
CCI edits, and clinical validation rules across commercial, auto/PIP, and workers'
Legal Services & Expert Witness Support
● Forensic Auditing: Conduct comprehensive forensic reviews of medical records, itemized
bills, and payment ledgers for cases entering litigation.
● Expert Reports & Affidavits: Author legally defensible, clear, and well-supported expert
reports outlining billing accuracy, unbundling, upcoding, or phantom charges.
● Testimony: Provide credible, articulate deposition and trial testimony as a designated
expert witness, translating complex coding systems (CPT, ICD-10, HCPCS, DRG) into
plain language for attorneys, judges, and juries.