What are the responsibilities and job description for the Medicare Risk Adjustment Educator position at MAXhealth?
MaxHealth is hiring a Medicare Risk Adjustment Educator for our growing organization! Have you been searching for a healthcare company that will value your contributions? You might just be perfect fit for this position if you thrive in a fast-paced environment are compassionate, service-oriented and can multitask with ease!
Candidates must have at least 3 years of experience.
Normal hours of operation are Monday- Friday 8:00am-5:00 pm.
RESPONSIBILITIES OF THE ROLE
- Main role is Provider Education. It is important that the clinical and diagnosis knowledge is solid to be able to perform in this position
- Perform audits of medical record to include consultations and diagnostic information to ensure continuity of care.
- Review medical record via EMR or paper chart to: verify the appropriateness of the diagnosis and procedural codes reported by the Physician and to evaluate any supporting documentation
- Identify, analyze and address documentation and/or coding discrepancies within the medical record.
- Arrange for ongoing training to Physicians, Clinicians and office staff on HCC coding and provide education based on audit findings.
- Review and complete system generated reports to correct or complete missing data as requested.
- Analyze MRA reports to identify and confirm unreported and/or unresolved medical conditions of members based on supportive medical documentation.
- Effectively communicate the audit process and results to appropriate management, and assist senior level staff in providing recommendations for process improvement so that productivity and quality goals can be met, and operational efficiency and financial accuracy can be achieved.
- Manage assigned workload efficiently and accurately while meeting deadlines, and complying with all HIPAA regulations.
QUALIFICATIONS FOR THE ROLE
- Certified Risk Adjustment Coder (CRC) certification required
- Registered Nurse (RN) or Licenses Practical Nurse (LPN) required or completion of foreign Medical School
- Minimum five years of coding experience using ICD-10- or equivalency
- Advanced knowledge of medical codes, terminology, abbreviations, anatomy & physiology, major disease, pharmacology and metric system.
This healthcare position earns a competitive wage, depending on experience. We provide fantastic benefits, including health benefits, a 401k plan, life insurance, long-term disability, paid holidays, and PTO (paid time off)!
ABOUT MAXHEALTH
MaxHealth is dedicated to simplifying healthcare and ensuring healthier futures. Founded in 2015, MaxHealth is a leading primary care platform focused on providing high-quality, integrated care to adults and senior patients throughout Florida. We provide care for more than 120,000 patients, most of which are beneficiaries of government-sponsored healthcare programs like Medicare, or of health plans purchased on the Affordable Care Act exchange marketplace. MaxHealth is a rapidly growing medical practice with more than 50 clinics spread across central and southern Florida. MaxHealth also partners with independent providers who are like-minded and utilizes its platform to help them provide high-quality care. We are customer-centered; compassionate; results-driven; proactive; collaborative; and adaptable in executing our vision to help patients live their best lives. Our mission is to deliver quality care, a simplified experience, and happiness. One patient at a time.
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