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Medicare Risk Adjustment Coding Educator Jobs in Texas

University Health

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 ...

University Health

Coding Educator/Auditor

San Antonio, TX · On-site

$23.50 - $26.75/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 ...

University Health

Coding Educator/Auditor

San Antonio, TX

$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 ...

Apex Health Solutions

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 ...

Apex Health Solutions

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 ...

Apex Health Solutions

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 ...

Apex Health Solutions

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 ...

UnitedHealth Group

Senior Coding Educator

Dallas, TX · Remote

$27 - $30.75/hr

... improving risk management, quality and revenue growth. Ready to help us deliver results that ... Provides continuing education supporting medical coders to stay updated with evolving regulations ...

UnitedHealth Group

Senior Coding Educator

Dallas, TX · On-site

$27 - $30.75/hr

... improving risk management, quality and revenue growth. Ready to help us deliver results that ... Provides continuing education supporting medical coders to stay updated with evolving regulations ...

Altegra Health

Remote Certified Coder

Dallas, TX · Remote

$22.25 - $30.50/hr

Extensive knowledge of ICD-9-CM outpatient diagnosis coding guidelines (with knowledge and demonstrated understanding of CMS HCC Risk Adjustment coding and data validation requirements is preferred)

Moffitt

$24 - $27.25/hr

Summary The MID REVENUE CYCLE CODING EDUCATOR SR, serves as the subject matter expert and ... Medicare Severity Diagnosis Related Groupers ("MSDRG"), All Patient Refined Diagnosis Related ...

Moffitt

$24 - $27.25/hr

Summary The MID REVENUE CYCLE CODING EDUCATOR SR, serves as the subject matter expert and ... Medicare Severity Diagnosis Related Groupers ("MSDRG"), All Patient Refined Diagnosis Related ...

Moffitt

$24 - $27.25/hr

Summary The MID REVENUE CYCLE CODING EDUCATOR SR, serves as the subject matter expert and ... Medicare Severity Diagnosis Related Groupers ("MSDRG"), All Patient Refined Diagnosis Related ...

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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 Texas?

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

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:

Medicare Risk Adjustment Coding Educator jobs near you

Risk Adjustment Data Analyst - CFHP

University Health

San Antonio, TX • On-site

$22.10 - $38.25/hr

Full-time

Posted 10 days ago

University Health System (San Antonio) rating

8.0

Company rating: 8.0 out of 10

Based on 64 frontline employees who took The Breakroom Quiz

90th of 898 rated healthcare providers

Job description

POSITION SUMMARY/RESPONSIBILITIES
The Risk Adjustment Data Analyst supports Community First Health Plans' Risk Adjustment program through data analysis, reporting, medical record retrieval, and performance monitoring activities. Coordinates with internal departments, provider networks, and external vendors to ensure accurate and timely collection, analysis, and reporting of risk adjustment data. Utilize health informatics and analytics tools to identify trends, monitor key performance indicators, support Hierarchical Condition Category (HCC) capture, and improve risk adjustment outcomes. Assists with medical record retrieval initiatives, data validation, provider performance analysis, and regulatory reporting to ensure compliance with CMS requirements and organizational goals.
EDUCATION/EXPERIENCE
Bachelor's degree in a related field preferred. Two (2) years of experience in healthcare data analysis and medical record retrieval required. Experience in Risk Adjustment, managed care, health plan operations, or healthcare analytics preferred. Knowledge of healthcare data, electronic health records (EHRs), and medical record retrieval processes preferred. Proficiency in Microsoft Excel and strong analytical, organizational, and communication skills required. Ability to work effectively with providers, vendors, and cross-functional teams.
CERTIFICATION
Coding certification within 2 years of employment (e.g., Certified Professional Coder - CPC, Certified Coding Specialist - CCS and/or data analytics certification (e.g., CHDA, Microsoft Power BI Data Analyst Associate) within two (2) years of employment, based on the requirements of their role.

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