[Hiring] Medical Coding Auditor I @Healthcare Management Administrators

Role Description

The Medical Claims Coding Auditor and Itemized Bill Reviewer plays a critical role in ensuring the accuracy, compliance, and cost-effectiveness of medical claims. This position is responsible for auditing medical records and itemized bills to validate coding accuracy, identify billing discrepancies, and support cost containment strategies. The ideal candidate has a strong background in medical coding, billing practices, and regulatory compliance, with a keen eye for detail and a commitment to integrity.

What YOU will do:

• Claims Auditing & Review
  • Conduct detailed audits of medical claims and itemized bills to ensure accuracy and compliance with coding standards (ICD-10, CPT, HCPCS).
  • Identify and document billing errors, upcoding, unbundling, and other discrepancies.
  • Review high-dollar claims and complex cases for potential overcharges or inappropriate billing.
• Coding Validation
  • Validate diagnosis and procedure codes against medical documentation.
  • Ensure coding aligns with payer policies, CMS guidelines, and industry best practices.
• Cost Containment & Recovery
  • Support cost containment initiatives by identifying opportunities for claim reductions or denials.
  • Assist in the development of audit strategies to target high-risk claims.
• Compliance & Quality Assurance
  • Stay current with changes in coding regulations, payer guidelines, and healthcare laws.
  • Participate in internal quality assurance programs to ensure audit consistency and accuracy.
  • Provide feedback and training to internal teams on coding and billing best practices.

Qualifications

• High School Diploma Required
• Certified Professional Coder (CPC), Certified Coding Specialist (CCS), or equivalent required.
• 1-3 years of health plan experience
• 1+ years of medical claims auditing, coding, or billing
• Familiarity with payer policies, CMS regulations, and medical necessity guidelines.
• Excellent analytical, organizational, and communication skills.
• Proficiency in claims systems, EMRs, and Microsoft Office Suite.
• Strong problem-solving and critical thinking skills
• Motivated self-starter with the ability to work independently
• Enjoys the pace and rhythm of a deadline-oriented environment requiring strong prioritization skills

Compensation

The base salary range for this position in the greater Seattle area is $29.80/hr - $35.57/hr for a level I and varies dependent on geography, skills, experience, education, and other job or market-related factors. While we are looking for level I, we may consider level II for highly qualified candidates.

Benefits

• Seventeen (IC) days paid time off (individual contributors)
• Eleven paid holidays
• Two paid personal and one paid volunteer day
• Company-subsidized medical, dental, vision, and prescription insurance
• Company-paid disability, life, and AD&D insurances
• Voluntary insurances
• HSA and FSA pre-tax programs
• 401(k)-retirement plan with company match
• Annual $500 wellness incentive and a $600 wellness reimbursement
• Remote work and continuing education reimbursements
• Discount program
• Parental leave
• Up to $1,000 annual charitable giving match

How we Support your Work, Life, and Wellness Goals

At HMA, we believe in recognizing and celebrating the achievements of our dedicated staff. We offer flexibility to work schedules that support people in all time zones across the US, ensuring a healthy work-life balance. Employees have the option to work remotely or enjoy the amenities of our renovated office located just outside Seattle with free parking, gym, and a multitude of refreshments. Our performance management program is designed to elevate career growth opportunities, fostering a collaborative work culture where every team member can thrive. We also prioritize having fun together by hosting in-person events throughout the year including an annual all hands, summer picnic, trivia night, and a holiday party.

Additional Information

HMA requires a background screen prior to employment. Protected Health Information (PHI) Access: Healthcare Management Administrators (HMA); employees may encounter protected health information (PHI) in the regular course of their work. All PHI shall be used and disclosed on a need-to-know basis and according to HMA’s standard policies and procedures. HMA is an Equal Opportunity Employer.