Supplemental Data Auditor

Location: Remote within the continental United States, excluding California, New York, Alaska, and Hawaii

Base pay: $63,300–$114,300 annually, plus eligibility for an annual incentive bonus.

Company

hirify.global is a health insurance organization focused on healthcare quality, compliance, and member services.

What you will do

• Audit and review electronic clinical records to verify alignment with medical record documentation.
• Oversee and review clinical data abstraction and extraction from electronic medical records.
• Audit supplemental files supplied by providers and vendors for HEDIS, QRS, and other quality measures.
• Identify documentation opportunities that improve audit outcomes and medical record validation.
• Support HEDIS reporting and accreditation requirements for national regulatory and accrediting agencies.

Requirements

• Bachelor’s degree or higher in a clinically related field.
• At least three years of healthcare industry or healthcare data experience.
• Knowledge of HEDIS reporting, related software tools, NCQA requirements, and technical data analysis in a formal audit environment.
• Understanding of claims, provider, membership, or similar database systems.
• Knowledge of federal and state quality reporting, health insurance regulations, and accreditation bodies such as URAC and NCQA.
• Strong written, verbal, interpersonal, analytical, and problem-solving skills, with proficiency in Word, Excel, and PowerPoint.

Nice to have

• Registered Nurse with an unrestricted state license.
• Clinical quality auditing experience.
• Experience with coding or a certified coding credential.
• Ability to learn new systems and technologies quickly.

Culture & Benefits

• Remote telecommute work within the stated United States locations.
• Curated development plans and professional development support.
• Health and wellness benefits, 401(k) savings plan, pension plan, and paid time off.
• Paid parental leave, disability and supplemental life insurance, employee assistance, and paid holidays.
• Tuition reimbursement and additional employee incentives.