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Medicare Risk Adjustment Education Specialist

2 months ago


Birmingham, Alabama, United States Complete Health Full time
Position Overview:

Join Complete Health as a vital member of our team dedicated to enhancing patient care through effective education and support. The Medicare Risk Adjustment Provider Educator plays a crucial role in identifying and implementing strategies to improve risk coding, documentation accuracy, and overall quality of care.

Key Responsibilities:

  • Develop, implement, and oversee all components of the Medicare Risk Adjustment (MRA) process, ensuring effective evaluation and education for both internal and external stakeholders.
  • Communicate a thorough understanding of Medicare Risk Adjustment principles, documentation standards, and coding regulations to various partners.
  • Analyze data reports to identify trends in documentation and coding, creating actionable opportunities for enhancement with both internal teams and external partners.
  • Ensure that provider documentation and diagnostic coding selections are precise, recommending improvements as necessary, including system-wide suggestions based on Electronic Medical Record (EMR) capabilities.
  • Continuously evaluate the knowledge and application of ICD-10 documentation and coding standards among providers.
  • Utilize reporting benchmarks and MRA success metrics to prioritize initiatives effectively.
  • Exhibit a professional and effective communication style, addressing challenges as they arise while fostering productive relationships.
  • Act promptly in routine scenarios, demonstrating strong attention to detail and excellent time management skills.
  • Work independently and adeptly solve complex issues as they occur.

Qualifications:

  • In-depth knowledge of Value-Based Care principles.
  • Exceptional interpersonal, public speaking, and presentation abilities.
  • Strong familiarity with various EMR systems and proficiency in Microsoft Office applications.
  • Willingness to travel to corporate locations as required.