Medical Coding Auditor (Outpatient Facility/APC Coding)

Location: Remote nationwide within the United States; occasional travel to hirify.global offices for training or meetings may be required.

Salary: $59,300–$80,900 per year, plus eligibility for a bonus incentive plan.

Company

hirify.global is a U.S. healthcare and insurance company serving Medicare, Medicaid, individual, family, military, and community healthcare needs.

What you will do

• Review outpatient medical claims and medical records to verify accurate, complete, specific, and appropriate procedure coding.
• Assess clinical documentation against coding guidelines and criteria for Ambulatory Payment Classification and outpatient facility services.
• Perform CPT and HCPCS procedure reviews using encoders and other coding resources.
• Conduct peer reviews, prepare reports, and support coding compliance and quality improvement initiatives.
• Enter and maintain claim and encounter information in relevant systems.
• Protect patient and physician confidentiality while following federal, state, hospital, and HIPAA-related information-release requirements.

Requirements

• Hold CPC, COC, CCS, ROCC, RHIA, or RHIT certification with at least 3 years of post-certification experience.
• Have at least 3 years of post-certification experience in outpatient specialty surgeries and procedures.
• Demonstrate strong knowledge of CPT and HCPCS coding and experience coding from operative reports.
• Have chemotherapy and/or therapeutic infusion experience.
• Exercise sound judgment and discretion when handling and disseminating information.
• Work independently in a production-based environment while managing multiple priorities and maintaining strong analytical, organizational, communication, and time-management skills.

Nice to have

• Five or more years of coding experience and outpatient facility auditing experience.
• Experience auditing radiology, gastroenterology, urinary, musculoskeletal, integumentary, anesthesia, general surgery, cardiology, respiratory, infusion, or interventional radiology coding.
• Ambulatory Payment Classification coding, radiation oncology coding, or prospective payment methodology experience.
• Experience with the claims lifecycle, including accounts receivable, and 3M Coder software.

Culture & Benefits

• Remote work from home during typical Monday–Friday business hours, 8 hours per day; some flexibility may be available based on business needs.
• A dedicated, interruption-free workspace and reliable internet connection with at least 25 Mbps download and 10 Mbps upload speeds are required.
• hirify.global provides appropriate telephone equipment; internet expense payments are available for eligible home-based associates in California, Illinois, Montana, and South Dakota.
• Benefits include medical, dental and vision coverage, 401(k), paid time off, holidays, parental and caregiver leave, disability coverage, and life insurance.
• Professional development and continuing education opportunities are available.

Hiring process

• Selected applicants may complete a prerecorded voice interview and/or SMS text interview through HireVue.
• Prerecorded interviews typically take 10–15 minutes; SMS interviews typically take 5–10 minutes, followed by review and potential next-round interviews.