Coding Denials Auditor (Medical Coding)

Location: Remote in the United States

Company

hirify.global provides specialty revenue cycle management solutions and intelligent automation for hospitals, health systems, and ambulatory surgery centers.

What you will do

• Conduct coding audits for outpatient facility and professional claims, reviewing procedure and diagnosis codes against medical documentation.
• Review billing accuracy and compliance with third-party payer coding and billing requirements.
• Investigate rejected and denied claims with revenue cycle teams and support corrections and appeals.
• Gather and analyze claims, medical records, documentation findings, and outcomes to make coding and billing decisions.
• Draft payer appeals using CPT Assistant, specialty society guidance, state fee schedules, and AAPC/AHIMA resources.
• Communicate audit findings, testing results, and complex coding topics to medical and non-medical colleagues.

Requirements

• Associate or bachelor’s degree, or an equivalent combination of education and experience.
• Current CPC, CCA, CCS, RHIT, or related AAPC/AHIMA certification.
• 5+ years of orthopedic surgery billing experience preferred, with strong medical coding, billing, accounts receivable, EOB, account management, and coding denials experience.
• Experience with complex claims, healthcare documentation systems, CAC/Encoder audits, DRGs, APCs, and NCCI concepts.
• Strong analytical, problem-solving, research, written, verbal, and interpersonal communication skills.
• Ability to work remotely, manage workload independently, attend regularly and predictably, and use Microsoft Office applications including Word, Excel, and Outlook.

Nice to have

• Strong background in orthopedic surgery billing and coding.
• Complex claims medical billing and coding experience.
• Experience interpreting policies and procedures and communicating complex subjects to varied audiences.

Culture & Benefits

• Remote work environment with an emphasis on flexibility and work-life balance.
• Professional growth and development support.
• Collaborative culture centered on shared goals, employee empowerment, and customer service.
• Equal opportunity workplace committed to a discrimination- and harassment-free environment.