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Medicare Risk Adjustment Coding Educator Jobs in Texas

Coding Educator

San Antonio, TX · On-site

$24.50 - $28/hr

Accrediting bodies include, but not limited to, the Centers for Medicare and Medicaid Services (CMS ... LICENSURE/CERTIFICATION The Coding Educator & Auditor must maintain a valid credential offered by ...

Coding Educator

San Antonio, TX · On-site

$25.10 - $40.25/hr

Accrediting bodies include, but not limited to, the Centers for Medicare and Medicaid Services (CMS ... LICENSURE/CERTIFICATION The Coding Educator & Auditor must maintain a valid credential offered by ...

Coding Educator

San Antonio, TX · On-site

$25.10 - $40.25/hr

Accrediting bodies include, but not limited to, the Centers for Medicare and Medicaid Services (CMS ... LICENSURE/CERTIFICATION The Coding Educator & Auditor must maintain a valid credential offered by ...

Coding Educator

San Antonio, TX · On-site

$24.50 - $28/hr

The Coding Educator ensures the TPR organization meets all governmental and payer coding guidelines ... Identify and mitigate organizational risk by validating that all billed services are accurately ...

Coding Educator

San Antonio, TX · On-site

$24.50 - $28/hr

The Coding Educator ensures the TPR organization meets all governmental and payer coding guidelines ... Identify and mitigate organizational risk by validating that all billed services are accurately ...

Coding Educator

San Antonio, TX · On-site

$24.50 - $28/hr

The Coding Educator ensures the TPR organization meets all governmental and payer coding guidelines ... Identify and mitigate organizational risk by validating that all billed services are accurately ...

Coding Educator/Auditor

San Antonio, TX · On-site

$25.10 - $40.25/hr

Accrediting bodies include, but not limited to, the Centers for Medicare and Medicaid Services (CMS ... Provides and monitors instructions/education provided to Providers, Coding, Risk, CDI, and Quality ...

Coding Educator/Auditor

San Antonio, TX · Remote

$25.10 - $40.25/hr

Accrediting bodies include, but not limited to, the Centers for Medicare and Medicaid Services (CMS ... Provides and monitors instructions/education provided to Providers, Coding, Risk, CDI, and Quality ...

Minimum of two (2+) years in CMS HCC Risk Adjustment Coding. * Minimum of two (2+) years ... Education:UNAVAILABLEEmployment Type: FULL_TIME

Certified Medical Coder

Houston, TX · On-site

$21.50 - $29.25/hr

... coding and compliance with Risk Adjustment requirements. Key Responsibilities * Follows CMS Risk Adjustment guidelines and has a complete understanding of their real-world application * Reviews ...

Certified Medical Coder

Houston, TX

$21.50 - $29.25/hr

... coding and compliance with Risk Adjustment requirements. Key Responsibilities * Follows CMS Risk Adjustment guidelines and has a complete understanding of their real-world application * Reviews ...

Coding Educator/Auditor

San Antonio, TX · On-site

$25.10 - $40.25/hr

Accrediting bodies include, but not limited to, the Centers for Medicare and Medicaid Services (CMS ... LICENSURE/CERTIFICATION The Coding Educator & Auditor must maintain a valid credential offered by ...

Showing results 21-40

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 job categories do people searching Medicare Risk Adjustment Coding Educator jobs in Texas look for? The top searched job categories for Medicare Risk Adjustment Coding Educator jobs in Texas are:

Business Development Executive (MedInsight)

Milliman

Houston, TX • On-site

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 10 days ago


Milliman rating

8.5

Company rating: 8.5 out of 10

Based on 7 frontline employees who took The Breakroom Quiz


Job description

Individual(s) must be legally authorized to work in the United States without the need for immigration support or sponsorship from Milliman now or in the future.  

Company Overview: 

Leading with our core values of Quality, Integrity, and Opportunity, MedInsight is one of the healthcare industry’s most trusted solutions for healthcare intelligence. Our company purpose is to empower easy, data-driven decision-making on important healthcare questions. Through our products, education, and services, MedInsight is making an impact on healthcare by helping to drive better outcomes for patients while reducing waste. Over 300 leading healthcare organizations have come to rely on MedInsight analytic solutions for healthcare cost and care management. 

MedInsight is a subsidiary of Milliman; a global, employee-owned consultancy providing actuarial consulting, retirement funding and healthcare financing, enterprise risk management and regulatory compliance, data analytics and business transformation as well as a range of other consulting and technology solutions. 

Position Summary: 

MedInsight is hiring a Business Development Executive to lead new-logo acquisition and expansion revenue across our risk adjustment portfolio. This is a selling specialist role: you will own a national territory selling MedInsight’s risk adjustment software and analytics to health plans, provider organizations, ACOs, MSOs, and other risk-bearing entities.

Risk adjustment is one of the highest-stakes and fastest-evolving areas in healthcare, where coding accuracy, documentation integrity, and audit readiness directly drive financial and compliance outcomes. You will sell to the leaders who own those outcomes (risk adjustment, coding, quality, finance, and compliance executives), and you will build credibility by understanding their priorities and engaging in meaningful business conversations rather than leading with product features.

This is a highly consultative, insight-led role that leverages Challenger-style selling principles. Reporting to the SVP of Sales & Growth and working alongside a peer group of BDEs, you will have dedicated support from marketing, sales development, and sales engineering. As MedInsight enters its next phase of growth, this is a high-visibility role with significant upside for career advancement.

 Primary Responsibilities: 

  • Develop deep expertise in MedInsight’s risk adjustment software and analytics, and in the surrounding market (CMS-HCC models, RADV, quality programs, value-based care, and the competitive landscape) to engage prospects as a credible advisor.
  • Build and execute a strategic national territory plan across health plans, provider organizations, ACOs, MSOs, and risk-bearing entities through targeted research, outbound prospecting, and insight-led engagement.
  • Identify, develop, and rigorously qualify opportunities using a structured sales methodology, mapping decision-makers and influencers across executive, clinical, financial, operational, and compliance functions.
  • Drive multi-threaded deal progression with stakeholders including C-suite executives, risk adjustment and coding/CDI leaders, quality and finance leaders, operations, and IT.
  • Lead consultative conversations that surface explicit and unrecognized needs across RAF performance, coding accuracy, documentation integrity, audit readiness, provider engagement, and both retrospective and prospective risk adjustment.
  • Deliver compelling commercial narratives that challenge the status quo and position MedInsight as a strategic solution for improving risk capture, compliance, operational efficiency, and reimbursement outcomes.
  • Partner closely with Marketing on outbound opportunity creation, campaign follow-up, event engagement, and account-based prospecting.
  • Collaborate with Sales Engineering, Product, Client Success, and Subject Matter Experts to deliver tailored demonstrations and ROI-driven business cases tied to measurable outcomes rather than features alone.
  • Consistently achieve and exceed quota and pipeline-generation targets, and maintain accurate forecast, opportunity, account, and activity data in Salesforce to support disciplined territory management.

Preferred Skills and Experience: 

  • 8 or more years of full-cycle new-business development in complex, consultative enterprise sales, preferably in healthcare technology, analytics, SaaS, or payment integrity / risk adjustment solutions.
  • Demonstrated success selling into healthcare payer, provider, and/or risk-bearing organizations, navigating complex buying groups and long sales cycles.
  • Direct experience selling risk adjustment, coding, CDI, quality, value-based care, population health, or related analytics solutions is strongly preferred.
  • Experience with the risk adjustment and reimbursement landscape (Medicare Advantage, ACA, Medicaid managed care, HCC coding, RAF optimization, RADV, and documentation/compliance) is strongly preferred.
  • Proven track record of building pipelines from scratch and executing territory plans in greenfield, competitive, or underpenetrated markets.
  • Demonstrated success negotiating and closing complex enterprise agreements with senior decision-makers, including CFOs, CIOs, COOs, CMOs, Chief Population Health Officers, and VP-level risk adjustment and compliance leaders.
  • Skilled at partnering with Sales Engineering and cross-functional teams to deliver outcome-oriented demonstrations and solution positioning.
  • Bachelor’s degree in business, healthcare administration, finance, economics, public health, or a related field preferred; advanced degree (MBA, MHA, MPH, or similar) a plus. Neither is required.

Key Competencies: 

  • Challenger Mindset: Leads with insight, teaches prospects something new about their risk adjustment performance, and creates urgency for change.
  • Consultative Seller: Uncovers root business issues and ties solutions to measurable financial, compliance, and operational outcomes.
  • Analytical & Strategic: Synthesizes market, financial, and operational data into sharp, customer-specific account strategies.
  • Entrepreneurial: Resourceful and proactive; creates momentum, opens doors, and builds pipeline in ambiguous, evolving markets.
  • Emotionally Intelligent: Builds trust quickly, navigates complex stakeholder dynamics, and turns feedback into growth.
  • Intellectually Curious: Stays ahead of shifting regulations, reimbursement models, and emerging market opportunities.
  • Effective Communication: A clear, confident, persuasive communicator in writing and in person, including at the executive level.
  • Organized & Resilient: Manages multiple opportunities and internal partnerships with precision, follow-through, and persistence.

Location

This role can be remote within the U.S. The expected application deadline for this job is August 30, 2026. 

Compensation

The overall salary range for this role is $104,900 - $199,065. For candidates residing in: 

  • Alaska, California, Connecticut, Illinois, Maryland, Massachusetts, New Jersey, New York City, Pennsylvania, Virginia, Washington, or the District of Columbia, the salary range is $120,635 - $199,065.  
  • All other locations the salary range is $104,900 - $173,100. 

A combination of factors will be considered, including, but not limited to, education, relevant work experience, qualifications, skills, certifications, etc. 

What makes this a great opportunity? 

  • Join an innovative, high growth company with a solid industry track record 
  • Bring your expertise and ideas to directly impact and help build the next generation of MedInsight products and solutions 
  • Be recognized for your contributions and impact
  • Work for a company that values your wellbeing and professional growth, offering a flexible work environment, generous benefits package, and investment in the development of your career 

Benefits 

We offer a comprehensive benefits package designed to support employees’ health, financial security, and well-being. Benefits include:

  • Medical, Dental and Vision – Coverage for employees, dependents, and domestic partners
  • Employee Assistance Program (EAP) – Confidential support for personal and work-related challenges
  • 401(k) Plan – Includes a company matching program and profit-sharing contributions.
  • Discretionary Bonus Program – Recognizing employee contributions
  • Flexible Spending Accounts (FSA) – Pre-tax savings for dependent care, transportation, and eligible medical expenses
  • Paid Time Off (PTO) – Begins accruing on the first day of work. Full-time employees accrue 15 days per year, and employees working less than full-time accrue PTO on a prorated basis
  • Holidays – A minimum of 10 paid holidays per year
  • Family Building Benefits – Includes adoption and fertility assistance
  • Paid Parental Leave – 11 weeks of paid leave for employees who meet eligibility criteria. 
  • Life Insurance & AD&D – 100% of premiums covered by Milliman
  • Short-Term and Long-Term Disability – Fully paid by Milliman

Equal Opportunity

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, national origin, disability, or status as a protected veteran. 

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#LI-SM1


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About Milliman

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Milliman delivers market-leading services and solutions to clients worldwide. Today, we are helping companies take on some of the world's most critical and complex issues, including retirement funding and healthcare financing, risk management and regulatory compliance, data analytics and business transformation.

Industry

Business management consulting

Company size

1,001 - 5,000 Employees

Headquarters location

Seattle, WA, US

Year founded

1947