Education Specialist – Risk Adjustment - Southwestern Health Resources

Education Specialist – Risk Adjustment

Risk Adjustment Department is looking for top skilled Education Specialist.  Is that you?

Work location:  Southwestern Health Resources Headquarters, 1601/1603 Lyndon B. Johnson Freeway, Farmers Branch, TX 75234.

Work environment: Risk Adjustment Department.

Please note: The Education Specialist will be an employee of Southwestern Health Resources (SWHR).   SWHR is a clinically integrated network formed by Texas Health Resources (THR) and University of Texas Southwestern Medical Center (UTSW). 

Work hours:  

·       Full-time, 40 hours per week.

·       Monday - Friday, Day shift.

·       This is a Hybrid position, requiring onsite workdays during the week, based on department business needs.

·       Require travel, approximately 80%, to Provider locations, within the Greater Dallas/Fort Worth Metroplex and surrounding areas, based on department business needs.

·       In-person attendance required at department meetings, trainings and/or other department authorized activities, at the above-mentioned address or other locations as directed by the department management.

What You Will Do: 

Responsible for providing Risk Adjustment education, chart review, and training to assigned practices must be willing to travel onsite. Rely upon independent judgment and decision-making at provider sites, whether conducting chart review or providing training/education, both for historical and/or real time data . 20%
Responsible for the collection and analysis of qualitative and quantitative data as it relates to Risk Adjustment specifically around prevalence and suspects . 20%
Contributes to the design and development of ad hoc reports and presentations for Risk Adjustment initiatives . 15%
Acts as Risk Adjustment documentation and coding expert, monitoring and answering questions for assigned clinics. Provides an instructional review of ICD-10-CM translations specific to Medicare Risk Adjustment coding. Responsible for identifying and influencing adoption of resources and processes to reach risk adjustment and quality goals of assigned . 10%
Develop and maintain strong working relationships with assigned SWHR clinic partners, including providers and support staff. 5%
Develops physician and staff remediation plans. 5%
Conduct audits on vendor coding platforms. 5%
Responsible for tracking, scheduling, and coordinating all education services, including onboarding activities for Risk Adjustment coding and documentation. Monitor education programs, timelines, and learner progress and report to leadership when appropriate. 5%
Meet with RAF leadership to partner on the Physician Risk Education Strategy . 10%
Speak and present at outreach events, and other duties as assigned. 5%

What You Need:

Education
H.S. Diploma or Equivalent Req Or
Associate's Degree Pref

Experience
3 Years Risk Adjustment Coding and Auditing or related experience Req and
1 Year Prior Coding Education Pref

Licenses and Certifications
CPC - Certified Professional Coder with credentialing from AHIMA and/or AAPC (RHIT, RHIA, CAC, CPC, CPC-A, COC, CPC-P, CCS) Upon Hire Req Or
Other CRC-Certified Risk Coder from AAPC Upon Hire Req