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Medicare Risk Adjustment Coding Educator Jobs in Florida

Msmc

Certified Risk Adjustment Coder

Hialeah, FL

$20.50 - $27.75/hr

Queries and provides feedback and education to physicians when identifying documentation deficiencies to improve accuracy of risk adjustment coding * Demonstrates understanding of risk adjustment ...

Cano Health

Risk Adjustment Coder

Jupiter, FL

The Risk Adjustment Coder is required to follow procedures and documentation policies regarding ... Provide coding support, education and training related to, quality of documentation, level of ...

Cano Health

Risk Adjustment Coder

Jupiter, FL · On-site

The Risk Adjustment Coder is required to follow procedures and documentation policies regarding ... Provide coding support, education and training related to, quality of documentation, level of ...

Centrum Health

Risk Adjustment Analyst

Doral, FL · On-site

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 ...

BHP

Director Value Base - BHP

Fort Lauderdale, FL · On-site

... Medicare Risk Adjustment Medical Coding and Billing compliance Healthcare auditing of documentation ... Education and Training- * Providing training and support to staff on value-based care principles ...

MASC Medical

Primary Care Physician

Bradenton, FL · On-site

Ongoing training in risk adjustment coding and Medicare quality programs (e.g., STARS) * Light call schedule (approximately 1 week every 6 weeks) Key Responsibilities * Provide comprehensive primary ...

MASC Medical

Primary Care Physician

Arcadia, FL · On-site

Ongoing training in risk adjustment coding and Medicare quality programs (e.g., STARS) * Light call schedule (approximately 1 week every 6 weeks) Key Responsibilities * Provide comprehensive primary ...

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Medicare Risk Adjustment Coding Educator information

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 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 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 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:
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Medicare Risk Adjustment Coding Educator jobs near you

Manager Risk Adjustment Program

BayCare Health System

Tampa, FL • On-site, Remote

Full-time

Re-posted 24 days ago

BayCare Health System rating

7.5

Company rating: 7.5 out of 10

Based on 399 frontline employees who took The Breakroom Quiz

235th of 887 rated healthcare providers

Job description

At BayCare, we are proud to be one of the largest employers in the Tampa Bay area. Our network consists of 16 community-based hospitals, a long-term acute care facility, home health services, outpatient centers and thousands of physicians. With the support of more than 30,000 team members, we promote a forward-thinking philosophy that's built on a foundation of trust, dignity, respect, responsibility and clinical excellence.
Position details:
Location: Tampa, FL (Remote - Must Reside in the State of Florida)
Status: Full Time, Salaried
Shift Hours: M-F, 8:00 am - 5:00 pm
The Manager Risk Adjustment Program:
  • Leads and implements risk adjustment strategies, operations and program development across BayCare PHSO and BayCare Plus consistent with BayCare goals and objectives.
  • Uses provider performance metrics and data to identify program/provider opportunities and gaps.
  • Works with physician/facility practices and key stakeholders to provide measurable and actionable solutions to meet and maintain best-practice documentation and HCC (Hierarchical Condition Category) and ICD-10 coding practices.
  • As a subject matter expert and preceptor, provides on-going supervision, education and training of risk adjustment team members related to coding and documentation responsibilities.
  • Works with BayCare Leadership to evaluate and adopt risk adjustment technology solutions.

Minimum Qualifications:
Required Education and Credentials: Bachelor's degree in business, technology, healthcare OR related disciplines required; and at least one of the following active certifications: Certified Professional Coder (CPC); Certified Risk Adjustment Coder (CRC); Certified Coding Specialist (CCS); or Registered Health Information Technician (RHIT).
Preferred Education and Credentials: Master's degree in business, technology, healthcare OR related disciplines
Required Experience: Minimum of three (3) years of relevant experience managing a risk adjustment program OR department with direct supervisory responsibility and budgetary accountability required, and minimum of five (5) years of management/leadership experience for a healthcare organization.
Preferred Experience: Two (2) or more years of experience in a lead risk adjustment role working with OR for Medicare Advantage health plans.
*Any equivalent combination of education and experience that provides the required knowledge, skills, and abilities to perform the essential duties and responsibilities of the position.
BayCare Values: Demonstrate a consistent commitment to BayCare Health System's core values of trust, respect, and dignity in all interactions with patients, families, team members, and the community, supporting our shared responsibility to achieve excellence in the communities we serve.
Leadership Competencies
  • Communication: Communicates in a clear, authentic, and transparent manner to meet the needs of others to ensure messages are received and mutually understood.
  • Emotional Intelligence: Demonstrates self-awareness and manages one's emotions. Recognizes and responds constructively to others' emotions and builds meaningful relationships.
  • Talent and Team Development: Develops team members and teams by empowering them, setting clear expectations, providing learning opportunities, and supporting ongoing growth.
  • Change Champion: Demonstrates a commitment to enhance performance by engaging and promoting change, continuous improvement, adaptability, and innovation.
  • Collaboration: Collaborates by sharing responsibility, transparent exchange of information, and collective problem-solving to achieve mutually beneficial solutions.
  • Results Driven: Takes ownership of outcomes by setting clear, measurable goals and aligning team efforts and resources to achieve them.
  • Inclusion and Belonging: Creates an inclusive environment that values all perspectives, respects individuality, and fosters an environment where all feel a sense of belonging.

Equal Opportunity Employer Veterans/Disabled

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