HSCRC Coding Reviewer (Healthcare)

TL;DR

HSCRC Coding Reviewer (Healthcare): Performing clinical documentation review and data abstraction to ensure accurate HSCRC payment methodologies with an accent on compliance auditing and medical record analysis. Focus on interpreting coverage policies, classifying clinical data, and providing professional feedback to hospitals.

Location: Remote (Must be based in the US)

Salary: $40–$45/hr

Company

hirify.global is a data-centric healthcare company leveraging AI and clinical expertise to improve health outcomes and operational efficiency.

What you will do

• Perform audit functions for the HSCRC Inpatient/Outpatient Data Abstract Review Contract.
• Conduct clinical documentation reviews and medical data abstraction.
• Interpret and apply coverage and payment policies to make medical necessity audit decisions.
• Classify clinical findings and provide qualitative and statistical analyses.
• Generate detailed audit work papers and professional deliverables.
• Provide feedback to hospitals regarding audit findings and rationales.

Requirements

• 5 years of experience in complex coding, quality assurance, or auditing involving ICD-10-CM/PCS, CPT/HCPCS, and DRG/APRDRG.
• Specific experience with State of Maryland payment systems.
• Bachelor’s degree in a related discipline or specialized licensure (e.g., RHIA, RHIT, RN, MD, CCS, CPC, CRC).
• Practical knowledge of HIPAA and other US confidentiality and privacy laws.
• Outstanding verbal and written communication skills for client interaction.
• Must be based in the United States.

Culture & Benefits

• Fully remote work arrangement.
• Healthcare benefits provided.
• Purpose-driven culture focused on straightforward communication and clinical expertise.
• Merit-based personnel processes.