Risk Adjustment Education Specialist

Support Services
21004675 Requisition #
603 Total Views
Southwestern Health Resources (SWHR CIN) seeks to hire a Risk Adjustment Education Specialist to work Full Time supporting the Risk Adjustment & Coding department.
Please note: Southwestern Health Resources Clinically Integrated Network (SWHR CIN) is an affiliated company of Texas Health and UT Southwestern.  If hired for this position, you will become a SWHR CIN employee rather than a Texas Health or UT Southwestern employee.
After SWHR Covid protocol ends, this position will office at the SWHR Corporate Headquarters, 1603 LBJ Freeway, Farmers Branch, Texas 75234
Salary range is Min. $27.27/hour to Max. $43.45/hour – based on relevant experience
Job Description
Assist in the collection and analysis of qualitative and quantitative data as it relates to risk adjustment specifically around missed opportunities, prevalence and suspects.
Identifies opportunities to improve accuracy and completeness for revenue impact.
Assist in the design and development of ad hoc reports and presentations for risk adjustment initiatives.
Meet with RAF leadership to partner on Physician Risk Education strategy.
Assist with the development and utilization of training and attendee tracking metrics and methodologies.
Assist with the development of physician and staff coding remediation plans.
Monitor education programs, timelines, learner progress and report to leadership when appropriate.
Provides onsite instruction per location (practice/clinic) for physician practice and office staff with ICD-10-CM coding training focusing on Medicare Risk Adjustment documentation and coding opportunities.
Provides instructional review of ICD-10-CM translations specific to Medicare Risk Adjustment-type diagnosis codes.
Performs education and chart review on all RAF initiatives.
Speak and present at outreach events.
The ideal candidate will possess the following qualifications:
Education & Experience
High School Diploma and 6 Years HCC Coding and Education Experience Required or
Associate's Degree and 4 Years HCC Coding and Education Experience Required or
Bachelor's Degree and 2 Years HCC Coding and Education Experience Required

Licenses and Certifications
CPC - Certified Professional Coder Upon Hire Required and
CRC - Certified Risk Coder Upon Hire Preferred

Ability to communicate and interact positively and professionally throughout all levels of the organization and with external customers.
Strong organizational skills in multiple settings, as well as the ability to exercise sound judgment and initiative.
Strong presentation skills.
Excellent problem solving and the ability to handle multiple projects, heavy workloads and deadlines in a fast paced dynamic environment.
Self-motivated with excellent follow through skills with ability to work independently with minimal to moderate supervision with demonstrated ability to work as an effective team member.
Strong working knowledge of MS Office products, including PowerPoint, Excel and Word; Adobe Captivate, Articulate and/or MLS relational database knowledge desired.
Ability to think strategically to develop new initiatives/processes that will achieve our specified targets.
Provide clear, appropriate and timely communication to promote a team environment throughout the department.
Ability to motivate team and hold team accountable for the results.
Ability to work effectively as an interdisciplinary team as well as independent.
Excellent knowledge of file transfer and audit processes as they relate to Risk Adjustment and Quality.

Individual Contributor

ADA Requirements
Working Indoors 67% or more

Physical Demands

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