Risk Adjustmt Coder Educator / Clinical Integration

Hartford Healthcare•Hartford, CT

33d•Onsite

About The Position

The Risk Adjustment Coder Educator develops and implements an enterprise-wide risk adjustment coding and documentation education program to support documentation practices among contracted providers that comply with CMS risk adjustment program requirements and ICD 10 coding guidelines. The Risk Adjustment Coder Educator will serve as a training resource for Risk Adjustment department staff and associated departments.

Requirements

Minimum: Bachelors degree or equivalent work experience
Minimum: of 3-5 years in medical claims coding required
Medical Coding Certification, Certified Professional Coder (CPC), Certified Coding Specialist – Physician (CCS-P) or Certified Coding Specialist (CCS)
Commitment to maintain complete confidentiality of patient health information
Will require on site auditing and training
Reliable transportation, insurance, and a valid driver's license
Must be able to excel in a fast paced business environment handling multiple priorities.
Must be highly effective in both written and oral communication
Must be able to exercise appropriate judgment when making decisions

Nice To Haves

Preferred: Bachelors or Associate’s degree
Preferred: Experience working with CMS, health insurers and medical providers strongly desired.
Experience with the nuances of diagnosis coding and risk adjustment programs preferred
Progressively responsible role with leadership experience and previous experience working in an educational/training role preferred.
Certified Risk Adjustment Coder (CRC) preferred (required within 6 months of hire)

Responsibilities

Oversees the development of complex and advanced ICD-10 and Hierarchical Condition Category (HCC) coding and documentation training programs including defining training objectives, developing training materials and tools
Implements documentation and coding training programs for Medicare Advantage contracted providers. Presents coding and documentation education in a variety of settings
Identify process improvements to capture data for Medicare Risk Adjustment
Builds relationships, programs, and processes alongside providers that will result in more accurate documentation and coding of diagnoses
Develops strategies to support knowledge transfer and testing to determine outcome and success of training
Provides individualized education to physicians and tracks performance over time
Creates “train the trainer guides” and participant materials
Demonstrate a face to face communication style and address issues as they arise
Support the team’s success by providing necessary resources and breaking down barriers
Provide necessary resources and helps to remove obstacles while demonstrating personal commitment to the group