Clinical Documentation Integrity & Claims Auditor

Devoted Health • Waltham, MA

1d • $58,000 - $85,000

About The Position

The Clinical Documentation Improvement Auditor supports Devoted Health’s Quality & Risk Adjustment strategy by reviewing medical records and auditing diagnostic information and ICD-10-CM coding. The work follows ICD-10-CM coding guidelines, internal coding protocols, and CMS guidance. Audits may be concurrent or retrospective and may result in diagnoses being added, removed, adjusted, or confirmed.

The role also supports provider and vendor education, guidance, and training on diagnostic documentation and compliant coding practices. It includes reviewing audit results with the CDI Manager and recommending process improvements. Some domestic travel is required to meet with and educate providers and support staff at office locations.

The position offers a stated salary range of $58,000–$85,000 per year. Devoted Health describes its mission as improving the health and well-being of older Americans through an integrated care platform and a family-oriented approach. The company states that it is an equal opportunity employer and values diversity and collaboration.

Requirements

• At least 3 years of outpatient CDI experience or at least 5 years of risk adjustment coding or auditing experience.
• CPC or CRC certification through AAPC, or CDI or CCS certification through AHIMA.
• Strong analytical and problem-solving skills.
• Strong oral and written communication skills.
• Strong organization and time-management skills.
• Ability to work independently.
• Ability to multitask.

Nice To Haves

• BA/BS in Nursing preferred but not required.
• Prior CPT coding experience is a plus.

Responsibilities

• Perform medical record audits based on organizational priorities, including concurrent Clinical Documentation Improvement workflows and retrospective audits.
• Review coding and audit results that may lead to the addition, deletion, adjustment, or confirmation of diagnoses.
• Review audit results with the CDI Manager.
• Assist in creating and communicating provider and vendor education about coding trends and opportunities for compliant coding practices.
• Assist the CDI Manager by recommending process improvements to enhance coding quality goals and outcomes.
• Perform other related duties as required or assigned, including provider education and training and working with vendor partners.
• Remain current on ICD-10-CM coding guidelines, AHA Coding Clinic guidance, and CMS Risk Adjustment guidance.
• Travel domestically to meet with and educate providers and support staff at office locations.

Benefits

• Employer-sponsored health, dental, and vision plans with low or no premium.
• Generous paid time off.
• $100 monthly mobile or internet stipend.
• Stock options for all employees.
• Bonus eligibility for roles below Director level; Sales roles may be eligible for commission.
• Parental leave program.
• 401(k) program.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed