Risk Adjustment Coding Auditor & Educator

* 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.
* 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.

- ** Comprehensive benefits:
** Medical, dental, vision, 401(k) match, paid time off, PTO cash outFor location-specific minimum wage details, see the following link:

DaVita (NYSE: DVA) is a comprehensive kidney care provider focused on transforming care to improve the quality of life for patients globally. The company is a leading provider of kidney care services in the U.S. and has been a leader in clinical quality and innovation for more than 20 years. DaVita is working to help increase equitable access to care for patients at every stage and setting along their kidney health journey—from slowing progression of kidney disease to streamlining the transplant process, from acute hospital care to dialysis  of March 31, 2022, DaVita served 200,800 patients at 2,809 outpatient dialysis centers in the U.S. The company operated an additional 346 outpatient dialysis centers in 11 other countries worldwide.

DaVita has reduced hospitalizations, improved mortality and worked collaboratively to help propel the kidney care community to adopt an equitable, high-quality standard of care for patients around the globe.

To learn more about what it means to be a part of our Village, visit .DaVita is an equal opportunity employer
- Male/Female/Veterans/Disabled. To learn more about what this means click .We maintain a drug-free workplace and perform pre-employment substance abuse testing and background verification checks.
We will consider for employment all qualified applicants, including those with criminal histories, in a manner consistent with the requirements of applicable state and local laws.
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