Consultant - Healthcare Compliance Auditor (HTS)

TL;DR

Consultant - Healthcare Compliance Auditor (HTS): Executing regulatory and reimbursement compliance audits for healthcare providers and payers with an accent on billing accuracy and clinical documentation review. Focus on applying CPT-4/HCPCS and ICD-10-CM guidelines to government programs like Medicare and Medicaid to identify risk areas and improve client outcomes.

Location: Remote (USA only). Candidates must be able to verify their legal right to work in the U.S. without company sponsorship.

Salary: $70,000 – $150,000

Company

hirify.global is a global consulting firm that combines academic expertise with business strategy and data analytics to address complex organizational challenges.

What you will do

• Plan and perform medical record audits to ensure coding accuracy and compliant claims submission.
• Develop audit methodologies based on key risk areas in coding and documentation.
• Analyze audit findings to identify trends and communicate recommended improvements to clients.
• Review medical records against CPT-4, HCPCS, and ICD-10-CM standards and CMS guidelines.
• Generate client deliverables and contribute to expert reports.
• Participate in business development initiatives and internal team training.

Requirements

• 4-year degree (BS or BA) required.
• Active coding certification from AAPC (CPC, CPMA) or AHIMA (CCC-P, AOC) required.
• 2+ years of experience in healthcare provider billing and coding.
• Advanced knowledge of Medicare rules, regulations, and coding systems.
• Must be authorized to work in the U.S. without sponsorship.
• Proficiency in Microsoft Office Suite, particularly Excel and PowerPoint.

Nice to have

• Certification in medical auditing.
• Experience with physician practice coding (primary care, dermatology, etc.), ASC, or post-acute coding.
• Previous experience in a consulting firm environment.
• Experience working within a health plan network auditing providers.

Culture & Benefits

• Collaborative team environment focused on agility and connectivity.
• Opportunity to work with industry experts and data scientists.
• Exposure to complex, high-impact healthcare policy and compliance challenges.
• Professional development through interdisciplinary collaboration.