... Medicare Advantage risk adjustment, Medicaid managed care, ACA risk adjustment, RADV audit ... fitFormal education or training in health information management, medical coding, healthcare ...
... Medicare Advantage risk adjustment, Medicaid managed care, ACA risk adjustment, RADV audit ... fitFormal education or training in health information management, medical coding, healthcare ...
... Medicare Advantage risk adjustment, Medicaid managed care, ACA risk adjustment, RADV audit ... fitFormal education or training in health information management, medical coding, healthcare ...
... Medicare Advantage risk adjustment, Medicaid managed care, ACA risk adjustment, RADV audit ... fitFormal education or training in health information management, medical coding, healthcare ...
... Medicare Advantage risk adjustment, Medicaid managed care, ACA risk adjustment, RADV audit ... fitFormal education or training in health information management, medical coding, healthcare ...
... Medicare Advantage risk adjustment, Medicaid managed care, ACA risk adjustment, RADV audit ... fitFormal education or training in health information management, medical coding, healthcare ...
... Medicare Advantage risk adjustment, Medicaid managed care, ACA risk adjustment, RADV audit ... fitFormal education or training in health information management, medical coding, healthcare ...
... Medicare Advantage risk adjustment, Medicaid managed care, ACA risk adjustment, RADV audit ... fitFormal education or training in health information management, medical coding, healthcare ...
Director, Provider Education & Risk Adjustment
Manhattan, NY · On-site
$175K - $200K/yr
... coding, and electronic health records. The Physician Educator distributes provider reports to ... Medicare managed care is highly preferred for this position. • Excellent verbal and written ...
Director, Provider Education & Risk Adjustment
Manhattan, NY · On-site
$175K - $200K/yr
... coding, and electronic health records. The Physician Educator distributes provider reports to ... Medicare managed care is highly preferred for this position. • Excellent verbal and written ...
Director, Provider Education & Risk Adjustment
Manhattan, NY · On-site
$175K - $200K/yr
... coding, and electronic health records. The Physician Educator distributes provider reports to ... Medicare managed care is highly preferred for this position. • Excellent verbal and written ...
Director, Provider Education & Risk Adjustment
Manhattan, NY · On-site
$175K - $200K/yr
... coding, and electronic health records. The Physician Educator distributes provider reports to ... Medicare managed care is highly preferred for this position. • Excellent verbal and written ...
Director, Provider Education & Risk Adjustment
Manhattan, NY · On-site
$175 - $200/hr
Elderplan and HomeFirst, our Medicare and Medicaid managed care health plans, are outstanding ... coding, and electronic health records. The Physician Educator distributes provider reports to ...
Director, Provider Education & Risk Adjustment
Manhattan, NY · On-site
$175 - $200/hr
Elderplan and HomeFirst, our Medicare and Medicaid managed care health plans, are outstanding ... coding, and electronic health records. The Physician Educator distributes provider reports to ...
Director, Provider Education & Risk Adjustment
Manhattan, NY · On-site
$175K - $200K/yr
... coding, and electronic health records. The Physician Educator distributes provider reports to ... Medicare managed care is highly preferred for this position. • Excellent verbal and written ...
Director, Provider Education & Risk Adjustment
Manhattan, NY · On-site
$175K - $200K/yr
... coding, and electronic health records. The Physician Educator distributes provider reports to ... Medicare managed care is highly preferred for this position. • Excellent verbal and written ...
Elderplan and HomeFirst, our Medicare and Medicaid managed care health plans, are outstanding ... coding, and electronic health records. The Physician Educator distributes provider reports to ...
Elderplan and HomeFirst, our Medicare and Medicaid managed care health plans, are outstanding ... coding, and electronic health records. The Physician Educator distributes provider reports to ...
Director, Provider Education & Risk Adjustment
Manhattan, NY · On-site
$175K - $200K/yr
... coding, and electronic health records. The Physician Educator distributes provider reports to ... Medicare managed care is highly preferred for this position. • Excellent verbal and written ...
Director, Provider Education & Risk Adjustment
Manhattan, NY · On-site
$175K - $200K/yr
... coding, and electronic health records. The Physician Educator distributes provider reports to ... Medicare managed care is highly preferred for this position. • Excellent verbal and written ...
Healthcare Practice Transformation Specialist
Passaic, NJ · On-site
$65K - $75K/yr
... risk adjustment and quality gap closure. * Conduct coding audits and provide education to providers on compliant documentation. * Monitor payer guidelines and coding updates, especially for Medicare ...
Quick apply
Healthcare Practice Transformation Specialist
Passaic, NJ · On-site
$65K - $75K/yr
... risk adjustment and quality gap closure. * Conduct coding audits and provide education to providers on compliant documentation. * Monitor payer guidelines and coding updates, especially for Medicare ...
Lead enterprise risk adjustment strategy for Medicare Advantage, Medicaid, and Commercial risk ... Oversee coding programs including chart review, CDI, education, and audit processes * Ensure ...
Lead enterprise risk adjustment strategy for Medicare Advantage, Medicaid, and Commercial risk ... Oversee coding programs including chart review, CDI, education, and audit processes * Ensure ...
Executive Director of Risk Adjustment
Manhattan, NY · On-site
$135 - $231/hr
Lead enterprise risk adjustment strategy for Medicare Advantage, Medicaid, and Commercial risk ... Oversee coding programs including chart review, CDI, education, and audit processes * Ensure ...
Executive Director of Risk Adjustment
Manhattan, NY · On-site
$135 - $231/hr
Lead enterprise risk adjustment strategy for Medicare Advantage, Medicaid, and Commercial risk ... Oversee coding programs including chart review, CDI, education, and audit processes * Ensure ...
Executive Director of Risk Adjustment
Manhattan, NY · On-site
$135 - $231/hr
Lead enterprise risk adjustment strategy for Medicare Advantage, Medicaid, and Commercial risk ... Oversee coding programs including chart review, CDI, education, and audit processes * Ensure ...
Executive Director of Risk Adjustment
Manhattan, NY · On-site
$135 - $231/hr
Lead enterprise risk adjustment strategy for Medicare Advantage, Medicaid, and Commercial risk ... Oversee coding programs including chart review, CDI, education, and audit processes * Ensure ...
Lead enterprise risk adjustment strategy for Medicare Advantage, Medicaid, and Commercial risk ... Oversee coding programs including chart review, CDI, education, and audit processes * Ensure ...
Lead enterprise risk adjustment strategy for Medicare Advantage, Medicaid, and Commercial risk ... Oversee coding programs including chart review, CDI, education, and audit processes * Ensure ...
Hierarchical Condition Category (HCC) Coding Specialist
New York, NY · Remote
$41.85/hr
... Centers for Medicare and Medicaid Services (CMS) coding guidelines, and Risk Adjustment Data ... EDUCATION Required * None Substitutions * None Preferred * Associate degree in medical billing ...
Hierarchical Condition Category (HCC) Coding Specialist
New York, NY · Remote
$41.85/hr
... Centers for Medicare and Medicaid Services (CMS) coding guidelines, and Risk Adjustment Data ... EDUCATION Required * None Substitutions * None Preferred * Associate degree in medical billing ...
Hybrid Coding Educator
New York, NY · On-site
$29.75 - $34/hr
The Coding Educator is responsible for overseeing and educating providers on the proper use of ... Responsible for auditing clinical documentation encounters to validate Risk Adjustment and HCCs ...
Hybrid Coding Educator
New York, NY · On-site
$29.75 - $34/hr
The Coding Educator is responsible for overseeing and educating providers on the proper use of ... Responsible for auditing clinical documentation encounters to validate Risk Adjustment and HCCs ...
Risk Adjustment Specialist
Manhattan, NY · Hybrid
$72K - $82K/yr
... Medicaid, Medicare and Affordable Care Act/QHP. This includes monitoring submission timelines ... Required Education, Training & Professional Experience * Bachelor's degree required, with a ...
Risk Adjustment Specialist
Manhattan, NY · Hybrid
$72K - $82K/yr
... Medicaid, Medicare and Affordable Care Act/QHP. This includes monitoring submission timelines ... Required Education, Training & Professional Experience * Bachelor's degree required, with a ...
Risk Adjustment Specialist
Manhattan, NY · On-site
$72K - $82K/yr
... Medicaid, Medicare and Affordable Care Act/QHP. This includes monitoring submission timelines ... Required Education, Training & Professional Experience * Bachelor's degree required, with a ...
Risk Adjustment Specialist
Manhattan, NY · On-site
$72K - $82K/yr
... Medicaid, Medicare and Affordable Care Act/QHP. This includes monitoring submission timelines ... Required Education, Training & Professional Experience * Bachelor's degree required, with a ...
ACO Risk Coding Specialist (Hybrid)
Bronx, NY · On-site
$27/hr
... to risk adjustment are brought to provider's attention. - Education providers on proper documentation and coding guidelines. - Suggest improvements to team workflows to ensure maximum coding ...
ACO Risk Coding Specialist (Hybrid)
Bronx, NY · On-site
$27/hr
... to risk adjustment are brought to provider's attention. - Education providers on proper documentation and coding guidelines. - Suggest improvements to team workflows to ensure maximum coding ...
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?
| Aspect | Medicare Risk Adjustment Coding Educator | Medicare Coding Specialist |
|---|---|---|
| Certifications | AHIMA or AAPC certifications, risk adjustment training | AHIMA or AAPC coding certifications, Medicare-specific coding credentials |
| Work Environment | Training sessions, educational settings, healthcare organizations | Clinical coding departments, healthcare facilities, insurance companies |
| Employer & Industry Usage | Hospitals, health plans, educational institutions | Hospitals, 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 New York?
For Medicare Risk Adjustment Coding Educator jobs in New York, the most frequently searched job titles are:
What job categories do people searching Medicare Risk Adjustment Coding Educator jobs in New York look for?
The top searched job categories for Medicare Risk Adjustment Coding Educator jobs in New York are:
What cities in New York are hiring for Medicare Risk Adjustment Coding Educator jobs?
Cities in New York with the most Medicare Risk Adjustment Coding Educator job openings:
$85/hr
Part-time
This job post has expired today. Applications are no longer accepted.
Job description
Specialised Part-Time Consulting OpportunityWe are sharing a specialised part-time consulting opportunity for United States-based healthcare coding and risk adjustment professionals experienced in HCC coding, Medicare Advantage risk adjustment, Medicaid managed care, ACA risk adjustment, RADV audit preparation, medical record review, documentation capture, and coding compliance.
This role supports current and upcoming remote consulting opportunities focused on AI-assisted risk adjustment coding evaluation, HCC recommendation review, documentation completeness assessment, and high-quality project execution. Selected professionals will apply coding and risk adjustment expertise to evaluate AI-generated HCC assignments, review documentation support, identify coding inaccuracies, and provide structured feedback based on detailed project criteria.
Key ResponsibilitiesProfessionals in this role may contribute to: Risk Adjustment & HCC Coding ReviewChart Review, RADV & Risk Score EvaluationStructured Coding Feedback & Quality ControlRisk Adjustment & HCC Coding ReviewReview risk adjustment coding workflows across Medicare Advantage, Medicaid managed care, and ACA risk adjustment programsEvaluate AI-generated HCC coding assignments and risk adjustment recommendations for clinical accuracy, documentation support, and regulatory complianceReview medical records to determine whether HCC-eligible conditions are fully and accurately supported by clinical documentationIdentify coding inaccuracies, unsupported diagnoses, documentation gaps, missed HCC opportunities, and compliance concernsChart Review, RADV & Risk Score EvaluationAssess retrospective and prospective chart review outputs for completeness, accuracy, and risk score relevanceEvaluate outputs related to CMS-HCC, RxHCC, and ACA HHS-HCC methodologiesSupport review of RADV audit preparation, audit response workflows, and risk adjustment data validation requirementsReview risk adjustment KPIs such as HCC capture rates, risk score accuracy, chart retrieval rates, and coding quality indicatorsStructured Coding Feedback & Quality ControlAnnotate AI-generated coding and risk adjustment outputs and provide structured feedback to support quality improvementExplain review decisions clearly, consistently, and with strong coding and compliance judgmentEvaluate outputs for alignment with CMS risk adjustment guidance, ICD-10-CM coding standards, Official Coding Guidelines, RAPS, EDGE submissions, and applicable compliance expectationsFollow detailed task instructions, quality criteria, and project-specific review guidelines accuratelyIdeal ProfileStrong candidates may have:5+ years of experience in risk adjustment coding, HCC coding, Medicare Advantage coding operations, or related healthcare coding workflowsAt least 2 years of leadership experience in risk adjustment, HCC coding, coding quality, chart review, or coding operationsDeep expertise in CMS-HCC, RxHCC, and/or ACA HHS-HCC risk adjustment methodologiesStrong knowledge of ICD-10-CM coding guidelines as applied to risk adjustment and HCC documentationExperience with RADV audit preparation, CMS compliance requirements, chart retrieval workflows, and risk adjustment quality reviewFamiliarity with RAPS and EDGE submission processesExceptional written and verbal English communication skillsHigh attention to detail and ability to identify coding inaccuracies, unsupported diagnoses, and documentation gaps in AI-generated outputsEducational BackgroundProfessional background in risk adjustment coding, HCC coding, medical coding, health information management, Medicare Advantage operations, managed care coding, value-based care, or coding compliance is highly relevantExperience in health plans, Medicare Advantage organizations, Medicaid managed care organizations, provider groups, value-based care organizations, or coding vendor environments may be especially valuablePractical experience with chart review systems, coding platforms, risk adjustment analytics tools, EHR documentation, and audit workflows may support project fitFormal education or training in health information management, medical coding, healthcare administration, nursing, clinical documentation, or a related healthcare field may be relevant depending on project scopeNice to HaveCRC, CCS, CPC, RHIA, or similar coding or health information credentialExperience with risk adjustment analytics platforms, chart retrieval systems, coding quality tools, or AI-assisted HCC coding workflowsBackground in health plan, Medicare Advantage, accountable care, or value-based care risk adjustment operationsFamiliarity with AI tools and comfort evaluating AI-generated risk adjustment and HCC coding contentExperience presenting risk adjustment performance, coding quality findings, or documentation improvement opportunities to actuarial, compliance, clinical, or executive teamsStrong ability to identify risk score integrity issues, documentation improvement opportunities, and coding compliance risksWhy This OpportunityApply HCC coding and risk adjustment expertise to structured remote healthcare project workContribute to high-quality AI-assisted risk adjustment coding and documentation reviewUse coding leadership, audit preparation experience, and compliance judgment in a focused review environmentWork on flexible assignments aligned with Medicare Advantage, managed care, ACA risk adjustment, and value-based care expertiseRemote structure with competitive hourly compensationContract DetailsIndependent contractor roleFully remote with flexible schedulingUnited States-based professionals are required for this opportunityPart-time project-based commitment depending on availability, onboarding status, and project needsCompetitive rates of up to $85 per hour depending on risk adjustment experience, HCC coding expertise, leadership background, and project scopeWeekly payments via Stripe or WiseProjects may be extended, shortened, or adjusted depending on scope and performanceWork will not involve access to confidential or proprietary information from any employer, client, or institutionAbout the PlatformThis opportunity is available through 24-MAG LLC. We connect experienced professionals with remote consulting opportunities across technical, evaluation, and project-based workstreams.
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