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Medicare Risk Adjustment Coding Educator Jobs in Florida

EDUCATION, TRAINING, AND PROFESSIONAL EXPERIENCE * Bachelor's degree is required. * Comprehensive ... and Medicare programs. * Five (5) or more years of hands-on SQL code development is required ...

ACN Physician

Debary, FL ยท On-site

$180K - $210K/yr

The Ideal Candidate Should Have a Proven Track Record of Working with Medicare Advantage Patients and Be Well-Versed in HEDIS Quality Measures, Medicare Risk Adjustment (MRA), RAF Score Optimization ...

ACN Physician

Debary, FL ยท On-site

$180K - $210K/yr

The Ideal Candidate Should Have a Proven Track Record of Working with Medicare Advantage Patients and Be Well-Versed in HEDIS Quality Measures, Medicare Risk Adjustment (MRA), RAF Score Optimization ...

ACN Physician

Debary, FL ยท On-site

$210K/yr

The Ideal Candidate Should Have a Proven Track Record of Working with Medicare Advantage Patients and Be Well-Versed in HEDIS Quality Measures, Medicare Risk Adjustment (MRA), RAF Score Optimization ...

HCC Coder

Lecanto, FL

$13.75 - $18.50/hr

... CMS risk adjustment methodology and Medicare Advantage models * Active coding credential preferred (CRC, CPC, CCS, or equivalent) * Proven experience with chart audits and provider education

HCC Coder

Lecanto, FL ยท On-site

$13.75 - $18.50/hr

... CMS risk adjustment methodology and Medicare Advantage models * Active coding credential preferred (CRC, CPC, CCS, or equivalent) * Proven experience with chart audits and provider education

HCC Coder

Lecanto, FL ยท On-site

$13.75 - $18.50/hr

... CMS risk adjustment methodology and Medicare Advantage models * Active coding credential preferred (CRC, CPC, CCS, or equivalent) * Proven experience with chart audits and provider education

HCC Coder

Lecanto, FL ยท On-site

$13.75 - $18.50/hr

... CMS risk adjustment methodology and Medicare Advantage models * Active coding credential preferred (CRC, CPC, CCS, or equivalent) * Proven experience with chart audits and provider education

HCC Coder

Lecanto, FL ยท On-site

$13.75 - $18.50/hr

... CMS risk adjustment methodology and Medicare Advantage models * Active coding credential preferred (CRC, CPC, CCS, or equivalent) * Proven experience with chart audits and provider education

MEDICAL CODING SPECIALIST

Miami, FL ยท On-site

$52 - $68/hr

Support managed care processes, including risk adjustment, quality initiatives, and utilization ... Experience working with managed care plans, including Medicare Advantage and other payer models

Showing results 21-40

Medicare Risk Adjustment Coding Educator information

What is a Medicare Risk Adjustment Coding Educator?

A Medicare Risk Adjustment Coding Educator is a healthcare professional responsible for training and educating medical coders, providers, and staff on risk adjustment coding guidelines as they pertain to Medicare. Their primary role is to ensure accurate and compliant coding of diagnoses, which affects risk scores and reimbursement under Medicare Advantage plans. They stay current with CMS policies and regulations, develop educational materials, and conduct audits to identify areas for improvement. By fostering correct coding practices, they help healthcare organizations optimize revenue and maintain compliance.

What are the key skills and qualifications needed to thrive as a Medicare Risk Adjustment Coding Educator?

To thrive as a Medicare Risk Adjustment Coding Educator, you need in-depth knowledge of ICD-10-CM coding, HCC risk adjustment models, and healthcare compliance, typically backed by certifications such as CPC, CRC, or CCS. Familiarity with coding software, electronic health record (EHR) systems, and auditing tools is essential for training and quality assurance. Excellent communication, presentation, and interpersonal skills help engage learners and clarify complex regulations. These skills ensure accurate coding practices, optimize revenue integrity, and support compliance in Medicare risk adjustment programs.

What are some common challenges faced by Medicare Risk Adjustment Coding Educators in ensuring coding accuracy across teams?

Medicare Risk Adjustment Coding Educators often encounter challenges such as varying levels of coding proficiency among staff, frequent updates to CMS guidelines, and the need to keep teams consistently informed about compliance changes. Educators must develop effective training methods tailored to different learning styles and regularly audit coding work to identify and address gaps. Collaboration with clinical staff and coders is key to maintaining high accuracy, and ongoing education is essential to support both new and experienced team members.

What is the difference between Medicare Risk Adjustment Coding Educator vs Medicare Coding Specialist?

AspectMedicare Risk Adjustment Coding EducatorMedicare Coding Specialist
CertificationsAHIMA or AAPC certifications, risk adjustment trainingAHIMA or AAPC coding certifications, Medicare-specific coding credentials
Work EnvironmentTraining sessions, educational settings, healthcare organizationsClinical coding departments, healthcare facilities, insurance companies
Employer & Industry UsageHospitals, health plans, educational institutionsHospitals, clinics, insurance providers

The Medicare Risk Adjustment Coding Educator focuses on training healthcare professionals in risk adjustment coding principles, while the Medicare Coding Specialist applies coding directly to patient records and claims. Both roles require coding certifications and knowledge of Medicare guidelines, but educators emphasize teaching and compliance, whereas specialists focus on accurate coding for reimbursement.

What are popular job titles related to Medicare Risk Adjustment Coding Educator jobs in Florida?

For Medicare Risk Adjustment Coding Educator jobs in Florida, the most frequently searched job titles are:

What job categories do people searching Medicare Risk Adjustment Coding Educator jobs in Florida look for?

The top searched job categories for Medicare Risk Adjustment Coding Educator jobs in Florida are:

$25.50 - $29/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 9 days ago


Job description

Our promise to you:

Joining AdventHealth is about being part of something bigger. Itโ€™s about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that together we are even better.

All the benefits and perks you need for you and your family:

  • Benefits from Day One: Medical, Dental, Vision Insurance, Life Insurance, Disability Insurance

  • Paid Time Off from Day One

  • 403-B Retirement Plan

  • 4 Weeks 100% Paid Parental Leave

  • Career Development

  • Whole Person Well-being Resources

  • Mental Health Resources and Support

  • Pet Benefits

Schedule:

Full time

Shift:

Day (United States of America)

Address:

2600 LUCIEN WAY

City:

MAITLAND

State:

Florida

Postal Code:

32751

Job Description:

Note: This position requires occasional travel to the Rocky Mountain and Mid-America regions, while primarily providing remote support to these areas from Florida.

  • Analyzes medical record documentation for HCC accuracy, correct documentation, and educational opportunities.
  • Provides education to physicians, advanced practice providers, and other key healthcare providers regarding the need for accurate, specific, and complete clinical documentation in the patient's medical record.
  • Serves as a subject matter expert in clinical documentation and coding best practices for both internal and external partners.
  • Participates actively in prospective program development, execution, and performance.
  • Assists the Clinical Documentation Integrity team by making recommendations for process improvements to further enhance program coding goals and outcomes.
  • Evaluates medical records to ensure Monitor, Evaluate, Assess, and Treat (M.E.A.T) criteria support the existence of submitted diagnosis codes.
  • Collaborates with each operational team and their leadership in a matrix relationship.
  • Provides direction and guidance to Risk Adjustment Coding Specialists and cross-functional team members within their respective clinics pertaining to Risk Adjustment.
  • Maintains current knowledge of ICD-10-CM codes, CMS HCC Model and updates, CMS documentation requirements, and the Official Guidelines for Coding and Reporting, as well as state and federal regulations.
  • Manages routine tasks and contributes to special project assignments to ensure ongoing compliance with federal and state privacy and data protection laws and regulations.
  • Utilizes strong analytical and problem-solving skills to assess, analyze, interpret, and report data, metrics, and trends.
  • Performs other duties as assigned.

Knowledge, Skills, and Abilities:

  • Ability to develop, evaluate and improve workflows including ability to create process documentation. [Required]
  • Knowledge of MS Office (Word, Outlook, Excel, and PowerPoint). [Required]
  • Knowledge of healthcare operations. [Required]
  • Knowledge and understanding of medical terminology and medical reporting. [Required]
  • Strong background in ICD-10-CM coding. [Required]
  • Communicate professionally in reporting results. [Required]
  • Ability to interact effectively with physicians and other health care professionals. [Required]
  • Able to be independent in daily work. [Required]
  • Able to identify, analyze and effectively solve problems. [Required]
  • Ability to prepare reports and presentations, and building/maintaining statistical spreadsheets. [Required]
  • Ability to function in a high-paced environment. [Required]
  • Utilize and demonstrate excellent critical thinking, problem-solving and deductive reasoning skills. [Required]
  • Excellent organizational skills [Preferred]
  • Excellent written and verbal English communication skills [Preferred]
  • Ability to work with people of various backgrounds and maintain good interpersonal relationships with department staff, ancillary staff, providers, operations, and administration. [Preferred]


Education:

  • Technical/Vocational School [Required]
  • Bachelor's [Preferred]


Field of Study:

  • Technical/Vocational School in Coding
  • Bachelor's in a related field


Work Experience:

  • 5+ years of coding experience, or experience with clinical documentation reviews and provider education [Required]


Additional Information:

  • N/A


Licenses and Certifications:
Registered Health Information Technician (RHIT) [Required] OR Certified Coding Specialist (CCS) [Required] OR Certified Risk Adjustment Coder (CRC) [Required] OR Certified Documentation Improvement Practitioner (CDIP) [Required] OR Certified Clinical Documentation Specialist-Outpatient (CCDS-O) [Required] OR Certified Clinical Documentation Specialist (CCDS) [Required] OR Certified Professional Coder (CPC) [Required]
Physical Requirements: (Please click the link below to view work requirements)
Physical Requirements - https://tinyurl.com/23km2677

Pay Range:

$50,211.20 - $93,392.00

Background Screening Requirement (Florida Law)


Certain positions are subject to Florida Level 2 background screening, including fingerprinting, as required by state law.


Applicants may review general information about Floridaโ€™s background screening requirements at the Florida Care Provider Background Screening Clearinghouse:
https://info.flclearinghouse.com/

This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances.