Risk Adjustment Education Specialist - HP Network Documentation Integrity

Risk Adjustment Education Specialist - HP Network Documentation Integrity

CHRISTUS Health

This role reports to the Risk Adjustment Manager of Coding Operations. Responsibilities include provider medical record audits, analysis of practice coding patterns, education, and training regarding risk adjustment, and identification of patterns to develop interventions at the provider level.

• Meets expectations of OneCHRISTUS Competencies.
• Subject matter expert for risk adjustment coding and CMS data validation.
• Collaborate with Provider Relations, Quality, and Medical Director departments to ensure compliance with CMS risk adjustment guidelines.
• Analyze MRA data to identify patterns and develop provider and market-level interventions to coordinate an educational work plan.
• Conduct provider education and training to ensure accurate CMS payment and improve care quality.
• Conduct training via provider offices, hospitals, webinars, conference calls, email correspondence, etc.
• Build positive relationships with assigned physicians and serve as a contact for questions or concerns.
• Identify practices requiring initial or ongoing additional training.
• Proficient in Prospective, Retrospective, and Concurrent review processes.
• Must have reliable transportation for face‑to‑face interactions with providers.
• Strong clinical knowledge of disease pathology and ability to identify clinical indicators related to chronic disease.
• Self‑motivated, energetic, self‑starter with ability to work autonomously.
• Results‑oriented, bias for action, with track record of achievement.
• Analytical with strong research, writing, and critical reasoning skills.
• Good communicator with concise speaking and writing skills, strong presentation ability.
• Good collaborator, oriented to team‑based work and open to change and process enhancement.
• Perform other duties as necessary.

• Associate degree or equivalent experience required.

• 5 years of experience in a hospital, physician setting, or Managed Care Organization as a medical coder.
• 2 years of experience in coding with knowledge of Medicare risk adjustment (HCC coding).
• Teaching, training, or educator/instructor role experience required; provider education preferred.
• Experience creating effective training materials and presentations (PowerPoint, Adobe, etc.).

• Certified Professional Coder (CPC) from AAPC required.
• Certified Risk Adjustment Coder (CRC) from AAPC preferred.
• An RN or LVN must obtain both CPC and CRC within 12 months of hire.

8 AM – 5 PM, Monday – Friday

Full Time

Irving, TX