Risk Adjustment Auditor and Physician Educator

Health Information Management | Full-Time | Renton, Washington

Help Improve Clinical Documentation and Support Better Patient Care

Valley Medical Center is seeking an experienced Risk Adjustment Auditor and Physician Educator to join our Health Information Management team. This role combines clinical documentation expertise, risk adjustment auditing, coding knowledge, data analysis, and physician education to help ensure the accurate and complete capture of patient conditions and the clinical complexity of the care we provide.

The ideal candidate brings strong experience in Medicare risk adjustment, medical record auditing, ICD-10-CM coding, and physician education, along with the ability to translate complex coding and documentation requirements into practical guidance for providers.

This is an opportunity to play a meaningful role in improving documentation quality, supporting value-based care initiatives, and partnering directly with physicians and organizational leaders.

Why Join Valley Medical Center?

Make an Impact Across the Organization

As a Risk Adjustment Auditor and Physician Educator, you'll help strengthen the connection between clinical care, documentation, coding, quality, and reimbursement.

You'll have the opportunity to:

• Perform comprehensive medical record audits to evaluate documentation and coding accuracy

• Identify opportunities for more complete and clinically appropriate documentation

• Educate physicians and other providers on documentation best practices

• Partner with the Physician Champion and organizational stakeholders to develop education strategies

• Support compliance with national coding and documentation standards

• Contribute to value-based care and risk adjustment initiatives

• Develop auditing processes, reporting, tools, and education programs

Collaborative Environment

This position works across departments and interacts with a wide range of professionals, including:

• Physicians and advanced practice providers

• Health Information Management

• Revenue Integrity

• Clinical and operational leaders

• Quality and value-based care teams

• Coding and clinical documentation professionals

• Other departments throughout Valley Medical Center

You'll serve as a subject matter expert and trusted resource, helping providers understand how accurate clinical documentation supports quality patient care and appropriate risk adjustment.

Position Overview

The Risk Adjustment Auditor and Physician Educator is responsible for developing and performing annual, periodic, and other quality assurance reviews of medical record documentation and coding to ensure appropriate capture of Hierarchical Condition Categories (HCCs) and accurate representation of patient complexity.

Using national coding guidelines and risk adjustment methodologies, you'll evaluate medical records, identify documentation and coding opportunities, develop corrective strategies, and provide targeted education to physicians and other providers.

Key Responsibilities

• Develop and maintain processes for annual, periodic, and quality assurance medical record audits

• Perform detailed medical record reviews related to risk adjustment and HCC capture

• Evaluate clinical documentation and coding for completeness, accuracy, and compliance

• Apply Medicare risk adjustment methodologies and ICD-10 coding concepts

• Interpret national coding and documentation guidelines and translate them into effective auditing practices

• Identify trends, gaps, and opportunities in provider documentation and coding

• Develop and implement remediation strategies for identified issues

• Partner with the Physician Champion to develop physician education and training

• Deliver one-on-one and group education to physicians and other providers

• Develop educational materials, presentations, and tools to support documentation improvement

• Provide feedback to providers in a professional, constructive, and educational manner

• Prepare reports and communicate audit findings to appropriate leaders and stakeholders

• Support continuous improvement of risk adjustment auditing and education processes

• Maintain current knowledge of coding guidelines, clinical documentation requirements, risk adjustment methodologies, and value-based care practices

• Collaborate with Revenue Integrity, Health Information Management, clinical operations, and other stakeholders on documentation and coding initiatives

What You'll Bring

Required Qualifications

• Bachelor's degree in health sciences, health management, or related field; equivalent related healthcare experience may be considered

• Minimum 3 years of experience in risk adjustment coding and medical record review

• Minimum 3 years of experience providing education and training to physicians

• Certified Professional Coder (CPC) or Certified Coding Specialist–Physician Based (CCS-P) certification

• Certified Risk Adjustment Coder (CRC) certification

• Proficiency with Microsoft Office applications, including Excel, Word, PowerPoint, Outlook, and Visio

Preferred Qualifications

• Certified Professional Medical Auditor (CPMA) certification

• Experience working within a health system or integrated healthcare organization

• Experience with value-based care and payer reimbursement methodologies

• Experience developing physician education programs

• Experience creating audit tools, reports, dashboards, or documentation improvement resources

Skills & Expertise

The successful candidate will demonstrate:

• In-depth understanding of chronic disease management and clinical documentation

• Strong knowledge of Medicare risk adjustment methodologies and HCC concepts

• Strong understanding of ICD-10-CM/PCS coding concepts and documentation requirements

• Knowledge of value-based methodologies, payer reimbursement, and healthcare coding conventions

• Ability to interpret national documentation and coding guidelines and apply them to auditing practices

• Ability to identify documentation and coding trends and develop effective remediation plans

• Strong critical-thinking, analytical, and problem-solving skills

• Excellent organization and attention to detail

• Strong time-management and prioritization skills

• Ability to work independently and take initiative

• Excellent verbal, written, presentation, coaching, and interpersonal skills

• Ability to communicate complex coding and documentation concepts clearly to physicians and other audiences

• Professional judgment and the ability to maintain composure in challenging situations

Work Schedule

Monday – Friday | Typically 8:00 AM – 4:30 PM

Flexibility may be required to meet department and organizational needs, including scheduling education sessions and meetings with providers and leaders.

Reports to: Director, Health Information Management and Revenue Integrity

About Valley Medical Center

Located in Renton, Washington, Valley Medical Center is affiliated with the University of Washington Medicine system and serves more than 600,000 residents throughout South King County.

Valley Medical Center is a 341-bed acute care hospital featuring a Level III Trauma Center and a comprehensive network of primary care, specialty care, and urgent care clinics.

Our organization brings together physicians, advanced practice providers, nurses, healthcare professionals, and support teams who are committed to providing high-quality, compassionate care to the communities we serve.

Live Where Others Vacation

Located just south of Seattle and Bellevue, Renton offers an exceptional quality of life with easy access to the best of the Pacific Northwest.

Enjoy:

• Puget Sound and waterfront communities

• Mountains, hiking, skiing, and year-round outdoor recreation

• Parks, trails, and abundant green space

• Diverse communities and excellent schools

• Easy access to Seattle, Bellevue, and the Eastside

• Shorter commutes compared with Seattle's urban core

Compensation & Benefits

Salary: $86,267 - $129,401 annually

Valley Medical Center offers a comprehensive benefits package that includes:

• Medical, dental, and vision insurance

• 403(b) retirement plan

• Life and disability insurance

• Generous paid time off

• Paid holidays and floating holidays

• Flexible spending accounts

• Employee Assistance Program

• Public Service Loan Forgiveness (PSLF) eligibility

• Professional development opportunities

Join Our Team

At Valley Medical Center, we care for our community like family. We are committed to fostering a culture of compassion, collaboration, innovation, inclusion, and excellence.

If you're an experienced risk adjustment and coding professional who enjoys auditing, analyzing, educating, and partnering with physicians, we'd love to hear from you.

Join Valley Medical Center and help strengthen the quality, accuracy, and integrity of healthcare documentation across our organization.