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Risk Adjustment Educator
Physician Health Partners (Visit Our Website And Join Our Talent Network!) - Denver, CO
posted 2 months ago
About the position
The Risk Adjustment Educator is responsible for educating and advising healthcare providers and practice staff on Medicare coding guidelines, with a focus on enhancing revenue opportunities. This role involves collaboration with various departments and health plans to develop educational materials and strategies that align with practice and IPA revenue goals. The position requires strong communication skills, problem-solving abilities, and a commitment to customer satisfaction, as well as ongoing self-development to stay current with industry changes.
Responsibilities
- Educate and advise providers and practice staff on Medicare coding guidelines.
- Collaborate with PHP departments and health plans to develop educational materials.
- Create and present the HCC education program to practices.
- Work with data analysts to develop meaningful practice-level reporting.
- Identify and solve data flow obstacles within assigned practices.
- Conduct risk adjustment chart reviews and educate on coding techniques.
- Build relationships with practices to enhance understanding of documentation and coding.
- Serve as a primary resource for physicians and office staff regarding coding and documentation.
- Maintain knowledge of changing health industry environments related to risk adjustment.
Requirements
- Bachelor's degree in a health-related field or equivalent experience.
- Certified Professional Coder (CPC) certification required.
- Certified Risk Adjustment Coder (CRC) certification required or commitment to obtain within one year.
- Three to five years of experience with medical records and/or medical coding, preferably in risk adjustment coding.
- Knowledge of healthcare insurance claims practices and compliance.
- Familiarity with Medicare rules and guidelines.
- Proficient in Claims Coding (CPT, HCPCs, ICD-10, HCFA 1500).
- Knowledge of risk adjustment categories and hierarchy preferred.
- Proficient in MS Office Suite and Electronic Medical Records.
Nice-to-haves
- Experience with Encoder and Coding Clinic software programs.
- Ability to synthesize data for educational training programs.
- Experience in responding to practice inquiries in a timely manner.
Benefits
- Competitive salary range of $59,155 - $78,884 per year.
- Full-time employment with a recognized top workplace.
