Risk Adjustment Education Specialist Job at CHRISTUS Health (Irving)

Job Description

This Job will report to the Risk Adjustment Manager of Coding Operations. Responsibilities will include provider medical record audits, analysis of practice coding patterns, education, and training regarding risk adjustment. You will also analyze data to identify patterns and development of interventions at the provider level.

Job Responsibility

Meets expectations of the applicable OneCHRISTUS Competencies: Leader of Self, Leader of Others, or Leader of Leaders
Subject matter experts for proper risk adjustment coding and CMS data validation
Work in conjunction with other departments, including Provider Relations, Quality, and the Medical Director, to ensure compliance with CMS risk adjustment guidelines
Analyze MRA data to identify patterns and development of provider and market-level interventions to coordinate an educational work plan for providers
Conduct provider education and training regarding risk adjustment to help ensure accurate CMS payment and improve care quality
This includes training venues such as provider offices, hospitals, webinars, conference calls, email correspondence, etc
Responsible for building positive relationships with assigned Physicians and serving as a contact for any questions or concerns that may arise
Identify those Practices that need initial or ongoing additional training
Perform other duties as necessary

Requirements

Associate degree or equivalent experience required
5 years of experience in a hospital, a physician setting, or a Managed Care Organization as a medical coder required
2 years of experience in coding with knowledge of Medicare risk adjustment (HCC Coding) required
Other experience in teaching, training, or an educator/instructor role is needed
Must have experience in creating effective training materials and presentations (PowerPoint, Adobe, etc.)
Certified Professional Coder (CPC) from AAPC is required
Certified Risk Adjustment Coder (CRC) from AAPC is preferred
An RN or LVN must obtain both CPC and CRC within 12 months of hire
Must be proficient in Prospective, Retrospective, and Concurrent review processes
Must have strong clinical knowledge of disease pathology and ability to identify clinical indicators related to chronic disease
Must be self-motivated: energetic, self-starter
can work autonomously with limited direction
Must be results-oriented: bias for action
demonstrated track record of achievement
drive for attainment of superior outcomes
Must be analytical: vital research, writing, analytical, and critical reasoning skills
Must be a good communicator: conveys thoughts and expresses ideas concisely and effectively both verbally and in writing
strong presentation skills
Must be a good collaborator: orientation to team-based work product and results, open to change and process enhancement
Must have reliable transportation to conduct ongoing face-to-face interactions with Providers

Nice to have

Provider education experience is preferred
Certified Risk Adjustment Coder (CRC) from AAPC is preferred

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Risk Adjustment Education Specialist

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