Risk Adjustment Educator
6 days ago
Alpine Physician Partners is seeking a highly skilled Risk Adjustment Educator to join our team. As a Risk Adjustment Educator, you will play a critical role in educating and advising healthcare providers and practice staff on Medicare coding guidelines, focusing on revenue enhancement opportunities.
Key Responsibilities- Collaborate with healthcare providers and practice staff to develop and implement effective coding strategies that meet Medicare guidelines and maximize revenue.
- Work closely with internal stakeholders to develop and maintain accurate and timely reporting packages for healthcare providers.
- Provide educational training programs to healthcare providers and practice staff on coding techniques and best practices.
- Identify and resolve coding-related issues and obstacles that prevent maximum code extraction and submission.
- Stay up-to-date on changing health industry environment related to the risk adjustment model and CMS expectations.
- Bachelor's degree in a health-related field or four years of related work experience.
- Certified Professional Coder (CPC) certification required.
- Certified Risk Adjustment Coder (CRC) certification required or commitment to obtain within one year of employment.
- Three to five years of experience with medical records and/or medical coding, preferably risk adjustment coding.
- Knowledge of healthcare insurance claims practice and compliance.
- Knowledge of Medicare rules and guidelines.
- Knowledge of Claims Coding (CPT, HCPCs, ICD-10, HCFA).
- Knowledge of risk adjustment categories and hierarchy preferred.
- Skilled in synthesizing data and questions to communicate a cohesive educational training program.
- Skilled in responding to practice inquiries in a timely and accurate manner.
- Skilled in working collaboratively with various parties to communicate an accurate and meaningful reporting package for practices.
- Knowledge of Electronic Medical Records, Encoder, Coding Clinic, and other software programs and internet-based applications as needed to fulfill position duties.
- Able to work effectively with physicians, practice staff, health plan/other external parties, and PHP multidisciplinary team to streamline efforts to meet HCC Coding goals.
- Able to work with sensitive data and relay potential issues or concerns in a diplomatic manner.
- Able to multi-task and meet deadlines.
- Able to communicate findings in a clear, concise manner, both internally and externally, including presentations.
The work environment is typically moderate, with occasional need to lift and/or move up to 25 pounds. The noise level is usually moderate.
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