Certified Senior Medical Coding Outpatient Auditor

Location: Remote nationwide within the United States; occasional travel to hirify.global offices for training or meetings may be required.

Salary: $71,100–$97,800 per year, plus eligibility for a performance-based bonus incentive.

Company

hirify.global is a U.S. healthcare and insurance company providing healthcare services to people and communities, including Medicare and Medicaid members.

What you will do

• Research claims anomalies and identify outpatient audit opportunities.
• Apply CPT/HCPCS coding guidelines and payer-specific reimbursement rules.
• Analyze APC grouping, edits, bundling, and the reimbursement impact of coding decisions.
• Review medical records against bills and validate code assignments and modifier usage.
• Document findings and support defensible audit determinations.
• Recommend recovery or education actions and partner with clinical and analytics teams on audit strategies.

Requirements

• Hold one of the following certifications: CPC, COC, CCS, ROCC, RHIA, or RHIT.
• Have 5+ years of post-certification experience with outpatient specialty surgeries and procedures.
• Knowledge of CPT/HCPCS coding guidelines and audit experience.
• Experience reading operative reports and coding from them.
• Maintain a dedicated, interruption-free workspace to protect member PHI and HIPAA information.
• Use an internet connection with at least 25 Mbps download and 10 Mbps upload speeds.

Nice to have

• 5+ years of prior coding experience.
• Outpatient facility auditing and outpatient data trend experience.
• APC coding and prospective payment methodology experience.
• Experience with 3M Coding software or Radiation Oncology coding.

Culture & Benefits

• Full-time schedule of 40 hours per week with a remote work arrangement.
• Medical, dental, and vision benefits.
• 401(k) retirement savings plan.
• Paid time off, company and personal holidays, and paid parental and caregiver leave.
• Short- and long-term disability coverage, life insurance, and wellness-focused benefits.