[Hiring] Clinical Documentation Integrity & Claims Auditor @Devoted Health

Role Description

The role of Clinical Documentation Improvement Auditor is a key part of Devoted’s Quality & Risk Adjustment strategy. This position helps to ensure the accuracy of diagnostic information and coding (ICD-10 CM) by performing audits and medical chart reviews. The Clinical Documentation Improvement Auditor will perform these duties in accordance with ICD-10 CM coding guidelines, internal coding protocols and CMS guidance. This role will assist with provider education, guidance and training related to diagnostic documentation and coding. This role requires some domestic travel to meet with and educate providers and support staff in office locations.

• Perform Medical Record audits based on organizational priorities, including both concurrent Clinical Documentation Improvement (CDI) workflows and retrospective auditing.
• Coding reviews and/or Audits may lead to the addition, deletion, adjustment, or confirmation of diagnoses.
• Review audit results with CDI Manager.
• Assist in creating and communicating provider and vendor education regarding trends and areas of opportunity regarding compliant coding practices.
• Make recommendations for process improvements to enhance coding quality goals and outcomes.
• Handle other related duties as required or assigned, including provider education and training and working with vendor partners.
• Remain current on ICD-10-CM coding guidelines, AHA Coding Clinic Guidance, and CMS Risk Adjustment guidance.

Qualifications

• BA/BS in Nursing preferred but not required.
• 3+ years as an outpatient CDI or 5+ years in risk adjustment coding/auditing.
• CPC or CRC certification through AAPC or CDI or CCS certification through AHIMA.
• Prior CPT coding a plus.

Requirements

• Strong analytical and problem-solving skills.
• Strong oral and written communication skills.
• Strong organization and time management skills.
• Ability to work independently.
• Ability to multi-task.

Benefits

• Employer sponsored health, dental and vision plan with low or no premium.
• Generous paid time off.
• $100 monthly mobile or internet stipend.
• Stock options for all employees.
• Bonus eligibility for all roles excluding Director and above; Commission eligibility for Sales roles.
• Parental leave program.
• 401K program.
• And more....