Certified Medical Claims Auditor (CPC/CIC)

Location: Fully remote, US-based only

Company

hirify.global provides integrated healthcare solutions for employers, payers, providers, and members, including care management, payment integrity, plan performance, and provider verification.

What you will do

• Review medical bills and claims to identify billing, coding, discrepancy, and savings opportunities.
• Analyze complex claim issues, reconsideration requests, provider inquiries, and disputes.
• Collaborate with the Negotiation team and conduct direct negotiations related to billing discrepancies.
• Communicate findings through detailed Bill Review Reports and support complex client inquiries.
• Identify billing trends, recommend process improvements, and contribute to policy development and training.
• Mentor junior analysts and ensure compliance with HIPAA and other regulatory standards.

Requirements

• Active CPC and/or CIC certification required.
• 3+ years of auditing, claims, review, and/or billing experience within a healthcare organization.
• Working knowledge of industry coding, ICD-10, CPT, HCPCS, and revenue codes.
• Knowledge of CMS guidelines.
• Excellent verbal and written communication, problem-solving, attention to detail, and organizational skills.
• Must be based in the United States and able to comply with company policies, including HIPAA requirements.

Nice to have

• Experience with DRG validation.
• Knowledge of health insurance, Medicare guidelines, and healthcare programs.
• Experience with RevCycle Pro, Encoder Pro, and/or SuperCoder.

Culture & Benefits

• Fully remote work with company-provided equipment.
• Quiet, distraction-free workspace, reliable internet, and adherence to security protocols using VPNs and approved devices and software.
• Medical, dental, and vision insurance with company subsidies, plus HSA, FSA, and DCFSA options.
• 401(k) with company match and immediate vesting.
• Paid vacation, sick leave, holidays, maternity and paternity leave, and an Employee Assistance Program.
• Pet insurance, employee discounts, and paid time off for philanthropic activities.