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Healthcare Coding Specialist
2 months 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 employee must be able to sit, use hands to finger, handle, or feel, and talk or hear for extended periods. The employee is occasionally required to stand, walk, reach with hands and arms, and stoop, kneel, crouch, or crawl.
