Coding Compliance Auditor

TL;DR

Coding Compliance Auditor (Medical Coding Compliance): Ensure accurate, complete, and timely coding by auditing medical records and clinical documentation against CMS, federal/state, and payer-specific requirements with an accent on E/M and outpatient coding accuracy, Medicaid/telehealth complexity, and audit-defensible remediation. Focus on identifying documentation gaps and coding discrepancies, validating fixes through follow-up audits, and communicating findings through written reports and targeted education.

Location: United States (Remote)

Salary: $75,000 - $90,000 base + annual bonus incentive

Company

hirify.global is a tech-enabled, pediatrician-led medical group delivering 24/7 virtual first and in-home medical, behavioral, and social care.

What you will do

• Review medical records and clinical documentation to ensure accurate, complete, and compliant coding aligned with CMS regulations, federal/state guidelines, and payer policies.
• Run routine and focused coding audits to find documentation gaps, coding discrepancies, and compliance risk areas.
• Partner with clinical leadership, revenue cycle, and compliance teams to resolve discrepancies and improve documentation practices.
• Provide actionable, audit-defensible recommendations and targeted education to providers and coding staff based on audit findings.
• Perform follow-up audits to validate remediation and sustain coding accuracy and compliance improvements.
• Serve as a pediatric, Medicaid, telehealth, and behavioral health coding subject matter expert; interpret and apply state-specific Medicaid and payer billing requirements.

Requirements

• CPMA required and CPC or CCS required.
• 5+ years of professional fee coding and auditing experience, specializing in E/M and outpatient coding across multiple clinical settings (telehealth experience preferred).
• Strong knowledge of medical terminology and coding standards/reference publications including CPT, HCPCS, ICD-10, and DRG.
• Prior coding or auditing experience in a Medicaid environment.
• Strong understanding of HEDIS measures and E/M coding, with the ability to evaluate documentation for quality measure compliance and audit-defensible coding.
• Familiarity with EMR software (e.g., Athena Health) and strong quantitative/analytical skills with clear verbal and written communication.

Culture & Benefits

• Competitive medical, dental, and vision insurance.
• Healthcare and Dependent Care FSA; Company-funded HSA.
• 401(k) with 4% match (vested 100% from day one) plus employer-paid short- and long-term disability.
• Life insurance at 1x annual salary; 20 days PTO + 10 company holidays + 2 floating holidays.
• Paid new parent leave and eligibility to participate in an employee equity purchase program (as applicable).