Medicare Risk Adjustment Educator

Oasis Health Partners®; United States; Remote; USD 48,000 - 55,000; Full time

Job summary

Oasis Health Partners is seeking a Medicare Risk Adjustment Educator to enhance their Clinical Coding Integrity Program. This role focuses on ensuring accurate clinical documentation and risk adjustment coding while supporting Primary Care Providers in rural markets. Candidates should have strong coding skills and experience in education within the healthcare field.

Benefits

Medical benefits

Dental benefits

Vision benefits

Generous time off plans

Development program

Qualifications

• 3+ years of risk adjustment coding experience required.
• 3+ years face-to-face/virtual physician education experience required.
• Familiarity with CMS risk adjustment processes preferred.

Responsibilities

• Review medical record documentation to ensure accurate coding.
• Evaluate records and ensure compliance with CMS guidelines.
• Provide feedback and education to Primary Care Providers.

Skills

Attention to detail

Communication skills

Technical savvy

Education

Associate degree in nursing or health information

Active coding certification (CPC, CRC, CCS, CCS-P)

Tools

MS Office applications

Job description

3 weeks ago Be among the first 25 applicants

Who You Are

You are a certified coder passionate about improving primary care. You possess Medicare Risk Adjustment knowledge, and your attention to detail ensures accurate documentation. You are excited to join a new company dedicated to supporting Primary Care Providers (PCPs) in rural markets.

Who You Are

You are a certified coder passionate about improving primary care. You possess Medicare Risk Adjustment knowledge, and your attention to detail ensures accurate documentation. You are excited to join a new company dedicated to supporting Primary Care Providers (PCPs) in rural markets.

Who We Are

Oasis Health (Oasis) is building healthier communities by advancing primary care. We partner with patients, providers and plans to provide personalized, local care for seniors in towns across America. We believe that patient needs come first, and that primary care is the foundation of patient-centric healthcare. With Oasis, patients receive better access and care. Providers receive the data, resources, and expertise to be successful in value-based care arrangements. Payers get the benefit of a solution that improves performance, drives growth and reduces the total cost of care in hard-to-engage markets.

Together, we will boldly advance primary care for those that need it most. We are excited for you to join us on this journey. We invite you to be a part of Oasis, where you’ll discover we do the right thing, build things together and go all in --- all while having fun!

Your Role

The Medicare Risk Adjustment (MRA) Educator is vital to the success of the Oasis Clinical Coding Integrity Program. As the MRA Educator, you help ensure accurate clinical documentation and risk adjustment coding across Oasis programs and practices, in compliance with CMS guidelines. You will have direct ownership over assigned practices and oversee their overall performance related to coding and documentation practices. Additionally, you will serve as the subject matter expert to your practices on risk adjustment, develop and present education topics and content, and act as a liaison between market partners, providers, and central operations.

Responsibilities

• Review medical record documentation and reports to ensure accuracy of HCC coding, identify recapture and suspect opportunities, verify proper documentation, and highlight areas for provider education and performance improvement
• Evaluate medical records to ensure Monitor, Evaluate, Assess, and Treat (M.E.A.T) criteria support the existence of submitted diagnosis codes
• Prepare and provide timely feedback to Primary Care Providers (PCPs) and their staff regarding coding review findings and documentation opportunities ensuring health conditions are properly documented and coded to the highest level of specificity
• Develop and deliver virtual or onsite presentations of coding review findings to practice partners
• Collaborate with the local market team to share results of specific coding activities and identified coding trends
• Serve as a subject matter expert in clinical documentation and coding best practices for both internal and external partners
• Assist Clinical Operations and Performance teams by making recommendations for process improvements to further enhance Oasis coding and documentation program goals and outcomes
• Be an active participant in prospective program development, execution, and performance
• Collaborate with other functional teams at Oasis regarding code capture, program and systems evaluation and feedback and other projects related to coding and documentation improvement, as appropriate
• Support education initiatives through effective use of technology platforms such as Doctustech and Cozeva
• Maintain current knowledge of ICD-10-CM codes, CMS HCC model and updates, CMS documentation requirements and coding guidelines, and state and federal regulations
  
  

Investment In Our Team

We invest in the personal and professional success of our team. We take care of our people and offer robust benefits including medical, dental, vision and generous time off plans. We are committed to supporting your growth with a development program that starts with onboarding and continues throughout your career. As an inclusive, passionate, and diverse team, you will partner with professionals who understand the importance of high-value, high-impact patient care.

About You

• You hold an associate degree in nursing, health information, or related field and an active coding certification (CPC, CRC, CCS, CCS-P) through AAPC or AHIMA
• 3+ years of risk adjustment coding experience
• 3+ years face-to-face/virtual physician education experience
• Working knowledge of CMS risk adjustment processes
• Experience working in value-based care models preferred
• Technical savvy with a high level of competence in basic computers and MS Office applications
• Strong presentation and written and verbal communication skills
• Ability to work in a very fast-paced environment and independently in a remote environment
  
  

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

Seniority level

• Seniority level

  Not Applicable

Employment type

• Employment type

  Full-time

Job function

• Industries

  Construction

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