Job Title: Medicare Risk Adjustment Educator
Exempt Status: Non-Exempt
Reports to: Production Coding Manager
Location: Corpus Cristi, TX
The Medicare Risk Adjustment Educator is responsible for identifying opportunities to improve provider documentation and creating a customized education plan tailored to each assigned provider. In this role, the Educator will integrate with the on-site staff to review medical records and arrange educational sessions with the provider aimed at quality of care and documentation improvements.
- On-site review and analysis of provider documentation with an eye toward compliance with CMS rules and regulations to capture risk adjusting (HCC) diagnoses
- Develop a customized education plan for each assigned provider to address opportunities for clinical document improvements identified during the review
- Provide one-on-one instruction with providers to address concepts identified by the Educator
- Integrate with the provider and their staff to identify process improvement opportunities
Skills and Competencies:
- Experienced Medicare Risk Adjustment (HCC) coder with a strong knowledge of ICD-10-CM diagnostic coding
- Possess excellent written, verbal, and interpersonal communication skills
- Experience providing feedback and gaining buy-in for recommendations
- Demonstrated ability to gather and analyze data to identify trends
- Proven track record of risk adjustment coding accuracy
- Familiarity with common EMR applications and proficient in Microsoft Office (Word, PowerPoint, Excel)
- Team-player with excellent time management, self-motivation, problem-solving, and attention to detail
- Travel required, at times within a 30-50 mile radius is expected.
- HS Diploma/GED required; AA degree or higher preferred or equivalent job-related experience
- Possess at least one of the following professional certifications: CPC, CRC, CCS, CCS-P, RHIT, RHIA; CPMA wand/or CPC-I is a plus
- Minimum of 4 years of HCC coding experience
- Minimum of 2 years of direct provider interaction
- A valid driver’s license and insurance/liability policy in the employee’s name is mandatory in applicable cities/states when a motor vehicle is necessary for the position. Management will notify such employees when applicable
While performing the duties of this job, the employee is frequently required to stand, walk, sit and lift. The employee must lift, carry and/or move medical records weighing up to 10 pounds. The Employee must have the ability to engage in repetitive motions such as utilizing a computer and reviewing medical records. Specific vision abilities required by this job include color vision. Requires prolonged sitting, some bending, stooping and stretching, requires eye-hand coordination and manual dexterity sufficient to operate a keyboard, photocopier, telephone, and other office equipment. Requires normal range of hearing and eyesight to record, prepare and communicate appropriate reports
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