Risk Adjustment Provider Educator
About The Position
The Risk Adjustment Provider Educator provides risk adjustment education to providers and support staff through interactive individual and group learning sessions, written guides and protocols, audits, and other methods. The role interprets risk adjustment data to identify education priorities and improvement opportunities, and provides analysis, reporting, training, education, and support to providers and staff. This is a full-time hybrid position, Monday through Friday, with travel in the Durham and Raleigh area. The role works with providers, clinical staff, practice leadership, and clinical and clerical teams to improve documentation and coding practices and risk adjustment performance.
Requirements
- Bachelor’s degree or equivalent work experience.
- At least 2 years of experience in training program design and development.
- At least 2 years of experience in risk adjustment and ICD-10 coding in the Medicare Risk Adjustment environment.
- Certified Risk Adjustment Coder (CRC) certification or similar.
- Strong critical-thinking and analytical skills, with in-depth knowledge of HCC Risk Adjustment models.
- Ability to analyze data, present results effectively through provider education, and monitor the effectiveness of education.
- Strong communication skills.
- Intermediate Excel skills, including PivotTables, VLOOKUP, and advanced formulas, plus data visualization skills.
- Intermediate Microsoft PowerPoint skills and ability to turn analytical output into clear visuals.
- In-depth knowledge of ICD-10-CM diagnostic coding.
- Strong time-management and organizational skills; self-motivated.
- Excellent customer service, problem-solving, and attention-to-detail skills.
- Ability to complete tasks promptly and follow through.
- Excellent written, verbal, and interpersonal communication skills.
- Initiative, tact, poise, neat personal appearance, and physical condition commensurate with the position’s requirements.
- Ability to manage multiple projects, prioritize, and meet deadlines.
- Ability to work independently in a fast-paced, cross-functional environment.
- Ability to work effectively as part of a team and adapt to shifting priorities.
Responsibilities
- Coordinate and lead in-person and virtual education sessions with providers, clinical staff, and practice leadership.
- Transform raw data into actionable insights to prioritize provider education and risk adjustment initiatives.
- Analyze and report data, providing useful insights.
- Identify documentation and coding improvement opportunities and guide providers on risk adjustment best practices.
- Analyze provider coding patterns and conduct follow-up audits after education to track documentation and coding improvements.
- Apply coding policies and guidelines when reviewing provider documentation.
- Stay current on applicable documentation guideline changes and rules.
- Build relationships with clinical and clerical teams to support open communication about the Risk Adjustment program and its components.
- Comply with policies and procedures regarding confidentiality of patient records, HIPAA, and system security.
- Provide excellent service to internal team members and patients, promote Millennium Physician Group’s values, and perform other related duties as assigned.
Benefits
- Three weeks of paid time off and eight paid holidays.
- Medical, dental, and vision coverage.
- Employer-paid basic life and short-term disability coverage after one year of full-time employment.
- 401(k) with employer match.
- Employee wellness program.
- Employee discount programs, including Tickets at Work and cell phone discounts.
- Dependent Care FSA.
- Voluntary life insurance.
- Long-term disability coverage.
- Critical illness coverage.
- Pet insurance.
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What This Job Offers
Job Type
Full-time
