Clinical Documentation Integrity – Claims Auditor

This is a fully remote position, open to applicants in United States.

📋 Description

• Report to the Manager of Clinical Documentation Improvement as a member of the Practice Operations team.

• Conduct medical record audits aligned with organizational priorities, including concurrent CDI workflows and retrospective auditing.

• Perform coding validation reviews that may result in the addition, deletion, adjustment, or confirmation of diagnoses.

• Initiate queries to providers for clarification on documentation.

• Leverage and assess AI tools and Human-in-the-Loop outputs.

• Support the creation and dissemination of education for providers and vendors regarding compliant coding trends and opportunities.

• Collaborate with the CDI Manager to enhance coding quality goals and outcomes.

• Stay updated on ICD-10-CM coding guidelines, AHA Coding Clinic Guidance, and CMS Risk Adjustment guidance.

• Ensure that diagnostic information, coding, and claims submitted on behalf of Devoted Medical are accurate, comprehensive, and compliant.

⛳️ Requirements

• Required certification: CPC or CRC (AAPC) or CDIP/CCDSR or CCS (AHIMA).

• Minimum of 3 years in outpatient CDI or 5 years in risk adjustment coding/auditing.

• Experience with AI tools, Copilots, and Google Suite.

• Prior experience in CPT coding is advantageous.

• Strong analytical and problem-solving capabilities.

• Exceptional oral and written communication skills for provider education.

• Capability to work independently and handle multiple tasks in a dynamic startup environment.

🏝️ Benefits

• Employer-sponsored health, dental, and vision plan with minimal or no premium.

• Generous paid time off policy.

• Monthly stipend of $100 for mobile or internet expenses.

• Stock options available for all employees.

• Bonus eligibility for all positions except those at the Director level and above.

• Commission eligibility for Sales roles.

• Parental leave program offered.

• 401K program available.