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Remote Risk Adjustment Provider Educator Jobs in Texas

Centene

Quality Practice Advisor

Corpus Christi, TX · On-site +1

$27.02 - $48.55/hr

... and risk adjustment. Provides education for HEDIS measures, appropriate medical record ... with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an ...

Datavant

Auditor, HCC Risk Adjustment Coding

Dallas, TX · Remote

$29 - $32/hr

... provide critical data solutions for organizations across the healthcare ecosystem - including ... Excellent written and verbal communication skills, ability to work in a remote environment and time ...

St. Luke's Health

Value Based Coder II

Houston, TX · On-site +1

$25.30 - $35.74/hr

Provide targeted provider 1:1 education on documentation best practices, HCC guidelines, and risk adjustment principles. 3. Compliance & Regulatory Insight: Continuously monitor and interpret ...

Altegra Health

Remote Certified Coder

Dallas, TX · Remote

$22.25 - $30.50/hr

Altegra provides end-to-end solutions to help improve payment integrity data, to support ... Altegra Health specializes in: 1. CMS HCC Risk Adjustment 2. HEDIS 3. Medical Record Reviews ...

Qcells

Risk Lead

Houston, TX · Remote

Remote RISK LEAD Hanwha Qcells USA Corp (Qcells USA), headquartered in Irvine, CA, specializes in providing utility-scale modules, solar photovoltaic (PV), and battery energy storage systems (BESS ...

Altegra Health

Remote Certified Coder

Dallas, TX · On-site +1

$22.25 - $30.50/hr

Altegra provides end-to-end solutions to help improve payment integrity data, to support ... Altegra Health specializes in: 1. CMS HCC Risk Adjustment 2. HEDIS 3. Medical Record Reviews ...

U2836

CODING IP TRAINER/EDUCATOR

Dallas, TX · Remote

$27 - $30.75/hr

DRGs, POA, risk adjustment, Vizient variables, PSIs, etc. * Collaborates with Coding Audit ... provides equal opportunity to all members of the University community. As an equal opportunity ...

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Remote Risk Adjustment Provider Educator information

What is the difference between Remote Risk Adjustment Provider Educator vs Remote Risk Adjustment Analyst?

AspectRemote Risk Adjustment Provider EducatorRemote Risk Adjustment Analyst
CredentialsCertifications in risk adjustment, healthcare coding, or related fieldsCertifications in data analysis, healthcare analytics, or coding
Work EnvironmentRemote, educational, training-focusedRemote, data analysis, reporting
Employer & IndustryHealth plans, healthcare providers, education companiesHealth plans, analytics firms, healthcare organizations

The Remote Risk Adjustment Provider Educator primarily focuses on training healthcare providers and staff on risk adjustment processes, requiring educational skills and certifications. In contrast, the Remote Risk Adjustment Analyst analyzes data to identify trends and improve risk scores. Both roles are remote and industry-specific but differ in their core functions and skill sets.

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Remote Risk Adjustment Provider Educator jobs near you

Auditor, Risk Adjustment Data Validation

San Antonio, TX • Remote

University Health
See more jobs at University Healthexternal

Full-time

Re-posted 25 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 Validation (RADV) Auditor is responsible for auditing medical records to validate ICD-10-CM coding accuracy and ensure compliance with Centers for Medicare and Medicaid (CMS) and RADV guidelines. This role focuses on performing detailed audits, analyzing data, and collaborating with providers and internal teams to support Hierarchical Condition Categories (HCC) ratio goals and risk adjustment improvement initiatives. The auditor prepares customized reports based on data analysis and provides actionable recommendations to enhance operational and clinical performance. Additionally, the position assists in managing data collection processes and develops procedures for monitoring, validating, and reconciling data for accuracy. Working closely with cross-functional teams, the auditor supports compliance, quality assurance, and risk mitigation strategies while contributing to the development of tools and processes to improve coding accuracy and audit efficiency.

EDUCATION/EXPERIENCE

Bachelor’s degree required. Coding certification (such as CPC, CRC, or CCS) is preferred, or candidates must demonstrate a willingness to obtain certification within 6–12 months of hire. Applicants should have 1–2 years of healthcare experience; prior coding experience is preferred. Strong analytical and problem-solving skills, coupled with attention to detail, are essential. Candidates must possess the ability to learn and apply ICD-10-CM coding principles, exhibit excellent communication and organizational skills. Proficiency in health information systems, electronic health records (EHRs), HEDIS, RADV, and claims data analysis is a plus.

LICENSURE/CERTIFICATION

Coding certification within 2 years of employment (e.g., Certified Professional Coder - CPC, Certified Risk Adjustment Coder-CRC)

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