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    Risk Adjustment Education Specialist - Irving, United States - Christus Health

    Christus Health
    Christus Health Irving, United States

    3 weeks ago

    CHRISTUS Health background
    Description

    Summary:

    This position will report to the RiskAdjustment Manager of Coding Operations. Responsibilities willinclude provider medical record audits, analysis of practice codingpatterns, education, and training regarding risk adjustment. Youwill also analyze data to identify patterns and development ofinterventions at the providerlevel.

    Responsibilities:

    • Meets expectations of the applicableOneCHRISTUS Competencies: Leader of Self, Leader of Others, orLeader of Leaders.
    • Subject matter experts forproper risk adjustment coding and CMS datavalidation.
    • Work in conjunction with otherdepartments, including Provider Relations, Quality, and the MedicalDirector, to ensure compliance with CMS risk adjustmentguidelines.
    • Analyze MRA data to identifypatterns and development of provider and market-level interventionsto coordinate an educational work plan forproviders.
    • Conduct provider education andtraining regarding risk adjustment to help ensure accurate CMSpayment and improve care quality.
    • Thisincludes training venues such as provider offices, hospitals,webinars, conference calls, email correspondence,etc.
    • Responsible for building positiverelationships with assigned Physicians and serving as a contact forany questions or concerns that may arise.
    • Identify those Practices that need initial or ongoing additionaltraining.
    • Must be proficient in Prospective,Retrospective, and Concurrent reviewprocesses.
    • This position does require theability to have reliable transportation to conduct ongoingface-to-face interactions with Providers.
    • Musthave strong clinical knowledge of disease pathology and ability toidentify clinical indicators related to chronicdisease.
    • Must be self-motivated: energetic,self-starter; can work autonomously with limiteddirection.
    • Must be results-oriented: bias foraction; demonstrated track record of achievement; drive forattainment of superior outcomes.
    • Must beanalytical: vital research, writing, analytical, and criticalreasoning skills.
    • Must be a good communicator:conveys thoughts and expresses ideas concisely and effectively bothverbally and in writing; strong presentationskills.
    • Must be a good collaborator:orientation to team-based work product and results, open to changeand process enhancement.
    • Perform other dutiesas necessary.

    Requirements:

    • Associate degree or equivalent experiencerequired.
    • 5 years of experience in a hospital,a physician setting, or a Managed Care Organization as a medicalcoder required.
    • 2 years of experience incoding with knowledge of Medicare risk adjustment (HCC Coding)required.
    • Other experience in teaching,training, or an educator/instructor role is needed, but providereducation experience is preferred.
    • Must haveexperience in creating effective training materials andpresentations (PowerPoint, Adobe,etc.)
    • Licenses, Registrations, orCertifications
    • Certified Professional Coder(CPC) from AAPC is required.
    • Certified RiskAdjustment Coder (CRC) from AAPC is required.
    • An RN or LVN must obtain both CPC and CRC within 12 months ofhire.

    Work Type:

    Full Time

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