DaVita Inc.
Seattle, WA, USA
* Conduct retrospective, concurrent, and prospective audits of medical records to validate the accuracy of ICD-10-CM codes and ensure documentation supports submitted diagnoses for Medicare Risk Adjustment (HCC coding).* Perform detailed internal and external coding audits on a regular basis as defined by compliance & department requirements, including for our nephrology partners.* Execute targeted audit plans, including performing targeted audits of identified HCC outliers.* Identify trends, patterns, and areas of opportunity for documentation and coding improvement through data analysis and audit findings.* Prepare and present formalized audit reports to leadership, summarizing findings, identifying risk areas, and recommending corrective action plans.* Assist in internal and external audits, including Risk Adjustment Data Validation (RADV) audits, by preparing documentation and responding to inquiries.* Perform necessary research to provide supportive regulatory and coding...