Risk Adjustment Coding Auditor & Educator

Risk Adjustment Coding Auditor & Educator

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This range is provided by DaVita Kidney Care. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more.

$56,500.00/yr - $84,000.00/yr

Posting Date: 12/10/2025
2000 16th St, Denver, Colorado, , United States of America

• Conduct retrospective, concurrent, and prospective audits of medical records to validate the accuracy of ICD-10-CM codes and ensure documentation supports submitted diagnoses for Medicare Risk Adjustment (HCC coding).
• Perform detailed internal and external coding audits on a regular basis as defined by compliance & department requirements, including for our nephrology partners.
• Execute targeted audit plans, including performing targeted audits of identified HCC outliers.
• Identify trends, patterns, and areas of opportunity for documentation and coding improvement through data analysis and audit findings.
• Prepare and present formalized audit reports to leadership, summarizing findings, identifying risk areas, and recommending corrective action plans.
• Assist in internal and external audits, including Risk Adjustment Data Validation (RADV) audits, by preparing documentation and responding to inquiries.
• Perform necessary research to provide supportive regulatory and coding guideline documentation.

• Deliver comprehensive training programs and educational materials for providers, coders, and clinical staff on risk adjustment, proper documentation, and coding guidelines.
• Provide one-on-one and group education sessions based on audit findings, tailoring content to address specific needs and knowledge gaps.
• Serve as a risk adjustment coding resource and subject matter expert, offering guidance and clarification on coding and compliance questions.
• Stay current with official coding guidelines from CMS, HHS, and other regulatory bodies to ensure all educational content is accurate and up-to-date.

• Maintain meticulous records of audit findings, educational sessions, and follow-up actions to ensure a clear audit trail.
• Participate in special projects related to process improvement, compliance, and coding initiatives as assigned.
• Maintain strict confidentiality of patient and proprietary information.
• Demonstrate and exemplify behavior consistent with DaVita’s core values:
  Service Excellence, Integrity, Team, Continuous Improvement, Accountability, Fulfillment, and Fun.

Certifications: Current coding certification from AAPC or AHIMA is required (CCA and CPC-A are not accepted).

• 3+ years of coding experience.
• 2-3 years’ minimum recent experience performing medical audits for diagnosis coding.
• Proven experience in developing and delivering education and training to clinical providers and coders is highly preferred.

• Strong computer skills, including the ability to utilize various EMR systems and Microsoft Office.
• Expert knowledge of ICD-10-CM and CMS-HCC risk adjustment models.
• Deep understanding of coding and documentation compliance, including CMS and HHS regulations.
• Excellent verbal and written communication skills, with the ability to present complex information clearly.
• Strong analytical and problem-solving skills with a high degree of accuracy and attention to detail.
• Demonstrated ability to work independently and collaboratively in a fast-paced, team-oriented environment.

• A "Community first, Company second" culture based on Core Values that really matter.
• Clinical outcomes consistently ranked above the national average.
• Award-winning education & training across multiple career paths to help reach your potential.
• Performance-based rewards based on stellar individual and team contributions.
• A comprehensive benefits package designed to enhance health, financial well-being & future.
• Dedication to caring for patients suffering from chronic kidney failure around the world.

New York Exempt:
New York City and Long Island: $64,350.00/year, Nassau,…