Medical Coder III

About the role

The Health Information Management (HIM) Medical Coder III of the Coding/Audit team will support DaVita’s HIM Coding and Audit operations. This position assists in developing or revising procedures to achieve maximum efficiency with the coding and auditing processes, mentors new and/or existing staff to achieve maximum autonomy and professional knowledge, and provides problem resolution for internal and external partners.

Responsibilities

• Review clinical notes, dialysis encounter logs, physician orders, diagnostic reports, and patient comorbidity documentation to extract relevant clinical data.
• Assign and sequence accurate ICD-10-CM, CPT, and HCPCS codes and appropriate billing modifiers according to official coding guidelines, CMS rules, and DaVita compliance standards.
• Validate, edit, and finalize automated coding recommendations generated through CWOW and Computer-Assisted Coding engines.
• Verify that patient diagnoses, dialysis prescriptions, and treatment details match billing requisitions.
• Investigate, correct, and appeal complex claim denials resulting from coding mismatches, bundling rules, medical necessity requirements, or payer-specific guidelines.
• Coordinate with Billing, Collections, and Clinical Documentation Integrity (CDI) teams to ensure root causes of recurring claim errors are addressed.
• Conduct documentation and coding audits in accordance with DaVita Clinical Medical Record Policies and Procedures (P&Ps) and state-mandated audit requirements.
• Ensure full adherence to HIPAA regulations and protect Protected Health Information (PHI) at all times.
• Act as a senior technical SME for Medical Coder I and II teammates, providing guidance on difficult coding scenarios and payer guidelines.
• Assist leadership in developing coding tip sheets, standard operating procedures, and training materials.

Qualifications

• Education: High School Diploma or equivalent required; Associate or Bachelor’s degree in Health Information Management (HIM) or a related field preferred.
• Certifications: Active medical coding certification required (e.g., CPC through AAPC, CCS / CCS-P / RHIT through AHIMA).
• Experience: 3-5+ years of progressive medical billing and coding experience (nephrology/dialysis, outpatient, or hospital coding experience preferred).

Skills

• In-depth knowledge of ICD-10-CM, CPT/HCPCS, NCCI edits, and payer reimbursement rules.
• Proficiency in Electronic Health Record (EHR) systems (e.g., CWOW, Epic) and practice management tools.
• Working knowledge of Microsoft Office applications (Excel, Teams, Outlook, Word).

Benefits

More than just pay, our DaVita Rewards package connects teammates to what matters most. Teammates are eligible to begin receiving benefits on the first day of the month following or coinciding with one month of continuous employment. Below are some of our benefit offerings.

• Comprehensive benefits: Medical, dental, vision, 401(k) match, paid time off, PTO cash out
• Support for you and your family: Family resources, EAP counseling sessions, access Headspace®, backup child and elder care, maternity/paternity leave and more
• Professional development programs: DaVita offers a variety of programs to help strong performers grow within their career and also offers on-demand virtual leadership and development courses through DaVita’s online training platform StarLearning.

At DaVita, we strive to be a community first and a company second. We want all teammates to experience DaVita as "a place where I belong." Our goal is to embed belonging into everything we do in our Village, so that it becomes part of who we are.

Pay

The Wage Range for the role is $26.50 - $40.50/hour.