Medicare Risk Adjustment Educator

4 weeks ago


Tampa, Florida, United States MaxHealth Full time
Job Title: Medicare Risk Adjustment Educator

MaxHealth is seeking a highly skilled Medicare Risk Adjustment Educator to join our team. As a key member of our organization, you will play a crucial role in ensuring the accuracy and quality of our risk adjustment coding practices.

Key Responsibilities:

  • Perform audits of medical records to ensure continuity of care and identify any discrepancies in coding and documentation.
  • Review medical records to verify the appropriateness of diagnoses and procedural codes reported by physicians.
  • Identify and address documentation and/or coding discrepancies within medical records.
  • Arrange for ongoing training for physicians, clinicians, and office staff on HCC coding and provide education based on audit findings.
  • Analyze MRA reports to identify and confirm unreported and/or unresolved medical conditions of members based on supportive medical documentation.

Requirements:

  • Certified Risk Adjustment Coder (CRC) certification required.
  • Registered Nurse (RN) or Licensed 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.

About MaxHealth:

MaxHealth is a rapidly growing medical practice with clinics spread across central and southern Florida. We offer convenient appointments, including telehealth and urgent care, and provide easy access to a complete range of patient-centered services.



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