Risk Adjustment Auditor - Educator

September 23

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Centene Corporation

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Contracting • Network Development • Managed Care

10,000+

Description

• Conduct provider medical record audits, analysis of practice coding patterns, education and training regarding risk adjustment to ensure accurate CMS payment and improve quality of care • Subject matter experts for proper risk adjustment coding and CMS data validation • Work in conjunction with other departments to ensure compliance of CMS risk adjustments guidelines are met • Conduct provider education and training regarding risk adjustment to help ensure accurate CMS payment and improve quality of care • Communicates QA results to the Medical Coding Specialists with suggestions for improvement and re-training topics

Requirements

• Bachelor’s degree or equivalent experience required • 5+ years of experience in a hospital, a physician setting or a Managed Care Organization as a medical coder • 2+ years of experience in coding with knowledge of Medicare risk adjustment (HCC Coding) • Required experience in teaching, training or an educator/instructor role required; but provider education experience is preferred • Preferred managed care experience • A license in one of the following is required: One of the following certifications are required at the time of hire: CPC or CCS Required • CPMA is required within the first year of employment • CRC required on the second year of employment

Benefits

• competitive pay • health insurance • 401K and stock purchase plans • tuition reimbursement • paid time off plus holidays • flexible approach to work with remote, hybrid, field or office work schedules