Risk Adjustmt Coder Educator / Clinical Integration

Hartford HealthCare; Hartford (CT); On-site; USD 85,000 - 120,000; Full time

Job summary

Hartford HealthCare's Risk Adjustment Coding education team seeks an educator to design and deliver enterprise-wide training on ICD-10, HCC coding, and CMS risk adjustment requirements. The role focuses on contracted providers and internal staff to improve documentation quality.

This on-site position requires 3–5 years in medical claims coding, CPC/CCS-P/CCS certification, and the ability to communicate complex concepts clearly.

Qualifications

• Must have 3–5 years in medical claims coding.
• CPC, CCS-P or CCS certification preferred or required within 6 months of hire.
• Strong on-site training and education delivery experience.

Responsibilities

• Oversee development of ICD-10 and HCC coding training programs.
• Implement documentation education for CMS risk adjustment requirements.
• Create training materials and train-the-trainer guides for staff and providers.
• Provide individualized education to physicians and monitor performance over time.
• Collaborate with Risk Adjustment team to improve data capture and coding accuracy.
• Coordinate on-site training sessions at Connecticut medical offices.

Skills

Training oversight

Medical coding expertise

Communication skills

On-site auditing

Education

Bachelor's degree or equivalent

Bachelor's or Associate’s degree

Job description

Location Detail: 80 Seymour Street (10008) Shift Detail: Requires ON-SITE visits to Medical Offices in Connecticut. Work where every moment matters. Every day, more than 40,000 Hartford HealthCare colleagues come to work with one thing in common: Pride in what we do, knowing every moment matters here. We invite you to become part of Connecticut’s most comprehensive healthcare network. The creation of the HHC System Support Office recognizes the work of a large and growing group of employees whose responsibilities are continually evolving so that we and our departments now work on behalf of the system as a whole, rather than a single member organization. With the creation of our new umbrella organization we now have our own identity with a unique payroll, benefits, performance management system, service recognition programs and other common practices across the system.

Position Summary

The Risk Adjustment Coder Educator develops and implements an enterprise-wide risk adjustment coding and documentation education program to support documentation practices among contracted providers that comply with CMS risk adjustment program requirements and ICD 10 coding guidelines. The Risk Adjustment Coder Educator will serve as a training resource for Risk Adjustment department staff and associated departments.

Position Responsibilities

Key Areas of Responsibility

• Oversees the development of complex and advanced ICD-10 and Hierarchical Condition Category (HCC) coding and documentation training programs including defining training objectives, developing training materials and tools
• Implements documentation and coding training programs for Medicare Advantage contracted providers. Presents coding and documentation education in a variety of settings
• Identify process improvements to capture data for Medicare Risk Adjustment
• Builds relationships, programs, and processes alongside providers that will result in more accurate documentation and coding of diagnoses
• Develops strategies to support knowledge transfer and testing to determine outcome and success of training
• Provides individualized education to physicians and tracks performance over time
• Creates “train the trainer guides” and participant materials
• Demonstrate a face to face communication style and address issues as they arise
• Support the team’s success by providing necessary resources and breaking down barriers
• Provide necessary resources and helps to remove obstacles while demonstrating personal commitment to the group

Working Relationships

This Job Reports To (Job Title): Manager Risk Adjustment Coding

Qualifications

Education

• Minimum: Bachelors degree or equivalent work experience
• Preferred: Bachelors or Associate’s degree

Experience

• Minimum: of 3-5 years in medical claims coding required
• Preferred:
• Experience working with CMS, health insurers and medical providers strongly desired.
• Experience with the nuances of diagnosis coding and risk adjustment programs preferred
• Progressively responsible role with leadership experience and previous experience working in an educational/training role preferred.

Licensure, Certification, Registration

• Minimum: Medical Coding Certification, Certified Professional Coder (CPC), Certified Coding Specialist – Physician (CCS-P) or Certified Coding Specialist (CCS)
• Preferred: Certified Risk Adjustment Coder (CRC) preferred (required within 6 months of hire)

Knowledge, Skills And Ability Requirements

• Commitment to maintain complete confidentiality of patient health information
• Will require on site auditing and training
• Reliable transportation, insurance, and a valid driver's license
• Must be able to excel in a fast paced business environment handling multiple priorities. Must be highly effective in both written and oral communication
• Must be able to exercise appropriate judgment when making decisions

We take great care of careers. With locations around the state, Hartford HealthCare offers exciting opportunities for career development and growth. Here, you are part of an organization on the cutting edge – helping to bring new technologies, breakthrough treatments and community education to countless men, women and children. We know that a thriving organization starts with thriving employees-- we provide a competitive benefits program designed to ensure work/life balance. Every moment matters. And this is your moment.