Risk Adjustment Auditor and Physician Educator

Valley Medical Center & Clinics; Renton (WA); Presencial; USD 86.000 - 129.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Medical, dental, and vision insurance

Retirement plan with employer-contrib.

Generous paid time off

Life and disability insurance

Flexible spending accounts

Employee wellness and assistance

Descripción de la vacante

Valley Medical Center & Clinics in Renton, WA is seeking a Risk Adjustment Auditor and Physician Educator to lead audits of medical records, ensure accurate HCC capture, and partner with physicians on documentation improvements.

Responsibilities include developing QA processes, delivering education and training to providers, and applying national coding guidelines to optimize billing and care quality. This role requires CPC/CCS-P CPMA and clinical coding expertise.

Formación

• Bachelor degree or higher in health sciences or related field.
• CPC or CCS-P certification required; CPMA preferred.
• Strong understanding of ICD-10-CM/PCS coding concepts.
• Experience delivering education to physicians and staff.

Responsabilidades

• Develop and report on QA reviews of medical records and coding to ensure accurate HCC capture.
• Partner with physicians to educate on documentation and coding best practices.
• Apply national coding guidelines to auditing processes and tools; meet deadlines.

Conocimientos

Chronic disease management

Medicare Risk Adjustment

ICD-10 coding concepts

Audit and education delivery

Critical thinking

Educación

Bachelor's degree in health sciences or related field

Certified Professional Coder (CPC)

Certified Coding Specialist-Physician Based (CCS-P)

Certified Professional Medical Auditor (CPMA)

Herramientas

Microsoft Office

Excel

Outlook

Descripción del empleo

Risk Adjustment Auditor and Physician Educator

• Full-time
• Shift: Day
• FTE: 1.0
• Exempt from Overtime: Yes
• Department: Non-Clinical
• Compensation: USD 86,267 - USD 129,401 - yearly

About Valley Medical Center & Clinics

Founded in 1947, Valley Medical Center & Clinics (VMCC) is the oldest and largest public hospital district in Washington state and the largest nonprofit healthcare provider in South King County. Valley serves more than 600,000 residents through a comprehensive network of more than 50 primary, urgent, and specialty care clinics across South King County, and a 341-bed acute care hospital located in Renton. As a Level III Trauma Center, Valley provides advanced emergency, medical, surgical, and specialty care, including cancer treatment, heart and vascular services, neurosciences, orthopedics, stroke and spine care, childbirth and neonatal services, and critical care. Guided by our mission of caring for our community like family, Valley is committed to improving the health and well-being of the vibrant communities we serve through accessible, compassionate, high-quality care. Learn more at valleymed.org.

The Risk Adjustment Auditor and Physician Educator is responsible for developing the process and reporting for performing annual, period, and other quality assurance reviews of medical record documentation and coding to ensure appropriate capture of Hierarchical Condition Categories (HCC) conditions. This position utilizes expertise and national coding guidelines as reference in performing medical record coding audits and in partnership with the Physician Champion, develops strategies for provider education and training.

Prerequisites

• Bachelor's degree in health sciences, health management or related field or equivalent related health experience required.
• Minimum 3 years of experience in risk adjustment coding and medical record review.
• Minimum 3 years of experience delivering education and training to Physicians required.
• Certified Professional Coder (CPC) or Certified Coding Specialist-Physician Based (CCS-P) certification required.
• Certified Professional Medical Auditor (CPMA) strongly preferred.
• Proficient in various computer applications, including Microsoft Office, Excel, Word, PowerPoint, Visio, and Outlook.

General Qualifications

• In depth clinical understanding of chronic disease management.
• Demonstrated proficiency in Medicare Risk Adjustment methodologies and ICD-10 coding concepts.
• Experience in health systems operations including knowledge of value-based methodologies, payer reimbursement and coding conventions.
• Demonstrated continuous learning in clinical medicine; practical understanding of ICD-10-CM/PCS and ability to educate physicians on the merits of best practice documentation strategies.
• Demonstrated ability to interpret national documentation and coding guidelines and translation to effective auditing practices and tools.
• Demonstrated ability to identify issues in documentation and coding practices and develop plan to remediate.
• Demonstrated ability to meet deadlines, with good time management and prioritization skills.
• Self-motivated and able to work independently.
• Demonstrated ability for critical thinking skills, with focus on assessment, evaluation, and teaching.
• Strong organization and analytical thinking skills; detail oriented.
• Strong verbal, written and presentation skills.

Build your future with Valley Medical Center & Clinics! Join a team that values its people and offers excellent benefits and opportunities to grow.

• Medical, dental, and vision insurance
• Retirement plan with employer contributions
• Generous paid time off, including vacation, sick leave, and holidays
• Life and disability insurance
• Flexible spending accounts
• Employee wellness and assistance programs

Valley Medical Center & Clinics is committed to equal employment opportunity (EEO) and nondiscrimination in all aspects of employment and participation in its programs.

We do not provide sponsorship opportunities at this time.

• Valley Medical Center & Clinics participates in E-Verify and will provide the federal government with your Form I-9 information to confirm that you are authorized to work in the U.S.

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