Risk Adjustment Documentation & Coding Educator
Company DescriptionPrivia HealthA$ cents A cents EUR zA' cents is a national physician platform transforming the healthcare delivery experience.
We provide tailored solutions for physicians and providers, creating value and securing their future.
Through high-performance physician groups, accountable care organizations, and population health management programs, Privia works in partnership with health plans, health systems, and employers to better align reimbursements to quality and outcomes.
Job DescriptionTitle:
Risk Adjustment Documentation & Coding EducatorEmployment Type:
FTEExemption Status:
ExemptReports to:
Associate Director, Population HealthMin.
Experience:
Mid-levelVA Travel Required:
50%, VA resident PreferredOverview Of The RoleThe Risk Adjustment Documentation & Coding Educator is responsible for supporting the growth and improvement of Privia Health's risk adjustment capabilities by conducting training, education, and management of coding and documentation improvement programs within Privia's Virgina Market.
The Educator will enhance the educational programs necessary to support value-based care initiatives impacting the Medicare Shared Savings Program and Medicare Advantage and Commercial value-based care agreements.
This individual will work in a matrixed organization to deliver complex ideas, support various key stakeholders, and assist with executing new risk adjustment initiatives.
The ideal candidate is an expert in coding and documentation guidelines, knows how to develop strong relationships with clinicians, and is an effective, strong communicator.
Successful candidates will also have extensive presentation experience in the following areas:
ICD-10-CM, CPT and HCPCS.
This is a market-based role and candidates must reside in the state of Virginia.
Primary Job DutiesUsing primarily the Hierarchical Condition Category (HCC) Risk Adjustment model, conduct training with individual and large provider groups, predominantly in-personEducate providers on the purpose of risk adjustment, as well as detailed and current risk adjustment documentation and coding trainingExecute on risk adjustment onboarding training plans with new providers in the marketAnalyze key coding performance indicators to determine those providers in need of initial or additional training.
Identify training priorities and proactively schedule provider trainings with provider's offices, individual providers and groups of providersTrain on effective EHR workflows to support coding and documentation for both known and suspected conditions.
Expert in how providers document and code in the EHR clinical record; serve as level one support for basic EHR customer support questions specific to risk adjustment workflowsMeet key performance indicators and quarterly objectivesAct as the internal subject matter expert and escalation point for risk adjustment, and coding documentationAccurately follow documentation and coding guidelines and legal requirements to ensure compliance with federal and state regulatory bodiesPerform other related duties, which may be inclusive, but not listed in the job descriptionQualificationsAssociates degree required, Bachelor's degree preferredCertified Professional Coder (CPC) required; Certified Risk Adjustment Coder (CRC) highly preferred or required within one year of employmentFive years' experience using ICD-10-CM, two years experience with risk adjustment training geared toward physiciansExtensive knowledge of documentation and coding guidelines established by the Center for Medicare and Medicaid Services (CMS) and the American Medical Association (AMA) for assignment of diagnostic and procedural codesExpert knowledge of Federal laws and regulations, including NCDs and LCDs affecting risk adjustment documentation and coding complianceMS Office Suite, Electronic Medical Records, Encoder, Coding Clinic, G-Suite, other software programs and internet based applications as needed to fulfill position dutiesA valid unrestricted drivers' license and a reliable vehicleMaintain patient, team member and employer confidentiality; comply with all HIPAA regulationsInterpersonal Skills & AttributesAble to have honest, difficult conversations with providers about diagnosis documentation and code assignmentWork effectively with physicians, Non-physician practitioners (NPP), practice staff, health plan/other external parties and Privia multidisciplinary team.
Establish and maintain effective working relationships with providers, management, clients and staffAbility to communicate effectively, verbally and in writing.
Excellent presentation skills in order to lead trainings for large groups of physicians and executivesUse a customer focused approach in dealing with conflict and resolution of problemsFlexible schedule and ability to travel for on site meeting with providers both before and after normal business hours of 8:
30am-5:
30pmExcellent time management skillsAdditional InformationAll your information will be kept confidential according to EEO guidelines.
A$ A' A' ?Technical Requirements (for Remote Workers)In order to successfully work remotely, supporting our patients and providers, we require a minimum of 5 MBPS for Download Speed and 3 MBPS for the Upload Speed.
This should be acquired prior to the start of your employment.
The best measure of your internet speed is to use online speed tests like This gives you an update as to how fast data transfer is with your internet connection and if it meets the minimum speed requirements.
Work with your internet provider if you have questions about your connection.
Employees who regularly work from home offices are eligible for expense reimbursement to offset this cost.
SDL2017.
Estimated Salary: $20 to $28 per hour based on qualifications.
We provide tailored solutions for physicians and providers, creating value and securing their future.
Through high-performance physician groups, accountable care organizations, and population health management programs, Privia works in partnership with health plans, health systems, and employers to better align reimbursements to quality and outcomes.
Job DescriptionTitle:
Risk Adjustment Documentation & Coding EducatorEmployment Type:
FTEExemption Status:
ExemptReports to:
Associate Director, Population HealthMin.
Experience:
Mid-levelVA Travel Required:
50%, VA resident PreferredOverview Of The RoleThe Risk Adjustment Documentation & Coding Educator is responsible for supporting the growth and improvement of Privia Health's risk adjustment capabilities by conducting training, education, and management of coding and documentation improvement programs within Privia's Virgina Market.
The Educator will enhance the educational programs necessary to support value-based care initiatives impacting the Medicare Shared Savings Program and Medicare Advantage and Commercial value-based care agreements.
This individual will work in a matrixed organization to deliver complex ideas, support various key stakeholders, and assist with executing new risk adjustment initiatives.
The ideal candidate is an expert in coding and documentation guidelines, knows how to develop strong relationships with clinicians, and is an effective, strong communicator.
Successful candidates will also have extensive presentation experience in the following areas:
ICD-10-CM, CPT and HCPCS.
This is a market-based role and candidates must reside in the state of Virginia.
Primary Job DutiesUsing primarily the Hierarchical Condition Category (HCC) Risk Adjustment model, conduct training with individual and large provider groups, predominantly in-personEducate providers on the purpose of risk adjustment, as well as detailed and current risk adjustment documentation and coding trainingExecute on risk adjustment onboarding training plans with new providers in the marketAnalyze key coding performance indicators to determine those providers in need of initial or additional training.
Identify training priorities and proactively schedule provider trainings with provider's offices, individual providers and groups of providersTrain on effective EHR workflows to support coding and documentation for both known and suspected conditions.
Expert in how providers document and code in the EHR clinical record; serve as level one support for basic EHR customer support questions specific to risk adjustment workflowsMeet key performance indicators and quarterly objectivesAct as the internal subject matter expert and escalation point for risk adjustment, and coding documentationAccurately follow documentation and coding guidelines and legal requirements to ensure compliance with federal and state regulatory bodiesPerform other related duties, which may be inclusive, but not listed in the job descriptionQualificationsAssociates degree required, Bachelor's degree preferredCertified Professional Coder (CPC) required; Certified Risk Adjustment Coder (CRC) highly preferred or required within one year of employmentFive years' experience using ICD-10-CM, two years experience with risk adjustment training geared toward physiciansExtensive knowledge of documentation and coding guidelines established by the Center for Medicare and Medicaid Services (CMS) and the American Medical Association (AMA) for assignment of diagnostic and procedural codesExpert knowledge of Federal laws and regulations, including NCDs and LCDs affecting risk adjustment documentation and coding complianceMS Office Suite, Electronic Medical Records, Encoder, Coding Clinic, G-Suite, other software programs and internet based applications as needed to fulfill position dutiesA valid unrestricted drivers' license and a reliable vehicleMaintain patient, team member and employer confidentiality; comply with all HIPAA regulationsInterpersonal Skills & AttributesAble to have honest, difficult conversations with providers about diagnosis documentation and code assignmentWork effectively with physicians, Non-physician practitioners (NPP), practice staff, health plan/other external parties and Privia multidisciplinary team.
Establish and maintain effective working relationships with providers, management, clients and staffAbility to communicate effectively, verbally and in writing.
Excellent presentation skills in order to lead trainings for large groups of physicians and executivesUse a customer focused approach in dealing with conflict and resolution of problemsFlexible schedule and ability to travel for on site meeting with providers both before and after normal business hours of 8:
30am-5:
30pmExcellent time management skillsAdditional InformationAll your information will be kept confidential according to EEO guidelines.
A$ A' A' ?Technical Requirements (for Remote Workers)In order to successfully work remotely, supporting our patients and providers, we require a minimum of 5 MBPS for Download Speed and 3 MBPS for the Upload Speed.
This should be acquired prior to the start of your employment.
The best measure of your internet speed is to use online speed tests like This gives you an update as to how fast data transfer is with your internet connection and if it meets the minimum speed requirements.
Work with your internet provider if you have questions about your connection.
Employees who regularly work from home offices are eligible for expense reimbursement to offset this cost.
SDL2017.
Estimated Salary: $20 to $28 per hour based on qualifications.
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