Risk Adjustment Auditor Educator

4 weeks ago


Carson City, Nevada, United States SilverSummit Healthplan Full time

Position Purpose: Conduct provider medical record audits, analysis of practice coding patterns, education and training regarding risk adjustment to ensure accurate CMS payment and improve quality of care.Subject matter experts for proper risk adjustment coding and CMS data validationAnalyze MRA data to identify patterns and development of interventions at the provider and market level to coordinate an educational work plan for WellCare contracted providers.Conduct provider education and training regarding risk adjustment to help to ensure accurate CMS payment and to improve quality of care.Works on additional risk adjustment audit requests (i.e. outside auditors' requests).2+ years experience in coding with knowledge of Medicare risk adjustment (HCC Coding).Required Other CPMA is required within the first year of employmentCentene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules.



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