Clinical Documentation Integrity – Claims Auditor

🔥 0 minutes ago

🇺🇸 United States – Remote

💵 $58k - $90k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

🏥📝 Medical Writer

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Devoted Health

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 2017

🏥 Healthcare

⚕️ Healthcare Insurance

🧘 Wellness

Healthcare • Healthcare Insurance • Wellness

Devoted Health is a healthcare company that offers Medicare Advantage plans designed to provide comprehensive health coverage with added benefits like dental, eyewear, gym memberships, and prescription drugs at competitive rates. The company emphasizes member support and service, ensuring that clients can easily navigate their benefits and access needed healthcare services. Devoted Health is committed to helping customers save money and enhance their health and wellness through a complete package of benefits and support.

📋 Description

• Report to the Manager, Clinical Documentation Improvement as part of the Practice Operations team • Perform medical record audits based on organizational priorities, including concurrent CDI workflows and retrospective auditing • Conduct coding validation reviews that may lead to adding, deleting, adjusting, or confirming diagnoses • Initiate provider queries for documentation clarification • Utilize and review AI tools and Human-in-the-Loop outputs • Assist in creating and communicating provider and vendor education about compliant coding trends and opportunities • Collaborate with the CDI Manager to improve coding quality goals and outcomes • Remain current on ICD-10-CM coding guidelines, AHA Coding Clinic Guidance, and CMS Risk Adjustment guidance • Ensure diagnostic information, coding, and claims submitted on behalf of Devoted Medical are accurate, complete, and compliant

🎯 Requirements

• CPC or CRC (AAPC) or CDIP/CCDSR or CCS (AHIMA) certification required • 3+ years in outpatient CDI or 5+ years in risk adjustment coding/auditing • Experience with AI Tools, Copilots, and Google Suite • Prior CPT coding experience is a plus • 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

🏖️ 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