Supervisor, Outpatient Audit Operations

Machinify

Supervisor overseeing outpatient audit operations, ensuring compliance and accuracy in coding for healthcare firm. Leading a remote team to optimize audit processes and performance metrics.

Posted 6/16/2026full-timeRemote • 🇺🇸 United StatesSeniorLeadWebsite

About the role

Key responsibilities & impact

Oversees and reviews audit determinations to ensure consistency in APC/APG grouping decisions, OPPS packaging interpretation, and outpatient coding policy application.
Uses data, reports, and experience to proactively identify potential backlogs and align resources to meet business needs and SLAs.
Effectively contributes to the development of medical review guidelines, coding education materials, and outpatient-specific training content.
Supports audit management and subject matter experts with new concept implementation and ongoing maintenance of outpatient medical review guidelines, including annual OPPS updates and CMS rule changes.
Accountable for achieving established productivity, quality, turnaround time, and employee engagement goals for the assigned team.
Ensures audit activities are performed in accordance with applicable regulatory requirements, client contracts, organizational policies, and industry standards.
Identifies process inefficiencies and implements solutions to improve accuracy, consistency, and productivity.
Monitors audit quality performance and collaborates with Quality Assurance and leadership teams to ensure consistency, accuracy, and defensibility of audit findings.

Requirements

What you’ll need

One of the following active certifications: RHIA, RHIT, CCS, CPC, COC
7+ years of facility outpatient coding experience in a hospital or health system setting, with demonstrated expertise in APC grouping and OPPS payment rules.
2+ years of outpatient facility coding audit, performing pre-payment and post-payment reimbursement reviews, or payment integrity experience in a provider, payer, or audit vendor environment.
3+ years of relevant management or leadership experience in a similar business environment (preferably experience overseeing remote coding audit staff).
Experience reviewing outpatient facility claims for coding accuracy and applying APG reimbursement guidelines during audit and overpayment identification activities.
Demonstrated success managing productivity, quality, turnaround time, and workforce performance metrics in a remote audit environment.

Benefits

Comp & perks

PTO, Paid Holidays, and Volunteer Days
Eligibility for health, vision and dental coverage, 401(k) plan participation with company match, and flexible spending accounts
Tuition Reimbursement
Eligibility for company-paid benefits including life insurance, short-term disability, and parental leave.
Remote and hybrid work options

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

outpatient codingAPC groupingOPPS payment rulescoding auditpre-payment reviewpost-payment reviewpayment integritycoding accuracyAPG reimbursement guidelinesproductivity metrics

Soft Skills

leadershipteam managementcollaborationproblem-solvingcommunicationorganizational skillsquality assuranceemployee engagementprocess improvementtraining development

Certifications

RHIARHITCCSCPCCOC