Lead - Healthcare - Coding Quality Auditor (Healthcare)

Location: Clifton, NJ, United States

Company

hirify.global provides digital engineering, artificial intelligence, automation, cloud engineering, advanced analytics, and business process services for global brands.

What you will do

• Perform retrospective, concurrent, and prospective coding audits across inpatient, outpatient, physician, and specialty services.
• Review medical documentation and validate diagnosis and procedure codes against coding, payer, regulatory, and organizational guidelines.
• Identify coding errors, documentation gaps, reimbursement opportunities, and recurring quality trends.
• Prepare audit reports with findings, recommendations, and corrective actions.
• Educate coders, providers, and clinical staff on coding updates, documentation improvement, and compliance.
• Support internal and external audits, policy development, process improvement, and coding quality programs.

Requirements

• 3–5 years of medical coding experience in a healthcare setting.
• At least 2 years of coding audit or quality review experience preferred.
• Current certification such as CPC, CPMA, CCS, CIC, RHIT, or RHIA.
• Extensive knowledge of ICD-10-CM, ICD-10-PCS, CPT, and HCPCS coding systems.
• Understanding of CMS regulations, NCCI, Official Coding Guidelines, and payer-specific policies.
• Experience with electronic health records, encoder software, Microsoft Office, and coding or audit software.

Culture & Benefits

• Full-time employment with responsibilities spanning coding quality, compliance, and continuous improvement.
• Work in a fast-paced environment with independent and collaborative responsibilities.
• Maintain confidentiality of protected health information in accordance with HIPAA regulations.
• Employment practices follow EEO and applicable legal requirements.