Note: The job is a remote job and is open to candidates in USA. Devoted Health is a healthcare company focused on improving the health and well-being of older Americans through integrated care, data, and AI. The Clinical Documentation Integrity & Claims Auditor performs medical record audits, validates coding and claims, initiates provider queries, supports education and process improvement, and ensures compliance with ICD-10-CM and CMS guidance.
Responsibilities
- Medical Record Audits: Perform audits based on organizational priorities, including concurrent CDI workflows and retrospective auditing
- Coding Validation: Conduct reviews that may lead to the addition, deletion, adjustment, or confirmation of diagnoses
- Provider Queries: Initiate queries for documentation clarification to ensure the highest level of clinical accuracy
- Innovation: Utilize and review AI tools and "Human-in-the-Loop" outputs to support modern auditing processes
- Education & Trends: Assist in creating and communicating provider and vendor education regarding trends and opportunities in compliant coding practices
- Process Improvement: Collaborate with the CDI Manager to make recommendations that enhance coding quality goals and outcomes
- Continuous Learning: Remain current on ICD-10-CM coding guidelines, AHA Coding Clinic Guidance, and CMS Risk Adjustment guidance
Skills
- * Required Certifications: CPC or CRC (AAPC) or CDIP/CCDSR or CCS (AHIMA)
- * Clinical/Coding Background: 3+ years in outpatient CDI or 5+ years in risk adjustment coding/auditing
- * Tech Savvy: Experience with AI Tools, Copilots, and Google Suite
- * Strong analytical and problem-solving skills
- * Excellent oral and written communication skills for provider education
- * Ability to work independently and manage multiple tasks in a fast-paced startup environment
- * Bonus Points: Prior CPT coding experience is a plus
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
- The total rewards package is for full time employees only; Intern and Contract positions are not eligible.
- Remote USA
Company Overview