Medicare Risk Adjustment Educator
4 weeks ago
MaxHealth is hiring a Medicare Risk Adjustment Educator for our growing organization Have you been searching for a healthcare company that will value your contributions? You might just be perfect fit for this position if you thrive in a fast-paced environment are compassionate, service-oriented and can multitask with ease Candidates must have at least 3 years of experience.
This healthcare position earns a competitive wage, depending on experience. We provide fantastic benefits, including health benefits, a 401k plan, life insurance, long-term disability, paid holidays, and PTO (paid time off)
Normal hours of operation are Monday- Friday 8:00am-5:00 pm.
Position can be performed in Florida or Puerto Rico
ABOUT MAXHEALTH
MaxHealth is a rapidly growing medical practice with clinics spread across central and southern Florida. With expanded locations and easy access to MaxHealth care, we offer convenient appointments, including telehealth and urgent care. Our patients choose us because we provide easy access to a complete range of patient-centered services. Achieving our mission of becoming Florida's leading national provider of high-value primary and specialty care services keeps us focused on reinventing the relationship between patients and healthcare providers for the better.
RESPONSIBILITIES OF THE ROLE
- Main role is Provider Education. It is important that the clinical and diagnosis knowledge is solid to be able to perform in this position
- Perform audits of medical record to include consultations and diagnostic information to ensure continuity of care.
- Review medical record via EMR or paper chart to: verify the appropriateness of the diagnosis and procedural codes reported by the Physician and to evaluate any supporting documentation
- Identify, analyze and address documentation and/or coding discrepancies within the medical record.
- Arrange for ongoing training to Physicians, Clinicians and office staff on HCC coding and provide education based on audit findings.
- Review and complete system generated reports to correct or complete missing data as requested.
- Analyze MRA reports to identify and confirm unreported and/or unresolved medical conditions of members based on supportive medical documentation.
- Effectively communicate the audit process and results to appropriate management, and assist senior level staff in providing recommendations for process improvement so that productivity and quality goals can be met, and operational efficiency and financial accuracy can be achieved.
- Manage assigned workload efficiently and accurately while meeting deadlines, and complying with all HIPAA regulations.
QUALIFICATIONS FOR THE ROLE
- Certified Risk Adjustment Coder (CRC) certification required
- Registered Nurse (RN) or Licenses Practical Nurse (LPN) required or completion of foreign Medical School
- Minimum five years of coding experience using ICD-10- or equivalency
- Advanced knowledge of medical codes, terminology, abbreviations, anatomy & physiology, major disease, pharmacology and metric system.
- May work in one of our Florida clinics or Remotely from home
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