Revenue Management Educator - Health Plan
Job Summary
The Revenue Management Educator is accountable for the successful development, implementation and delivery of educational and training resource materials to assist providers in coding accuracy. The Educator develops and implements strategic action, quality improvement and risk management plans. The Educator provides overall educational support and coding quality assurance activities to both internal and external stakeholders as it relates to Medicare Advantage, ACA/Exchange and Medicaid risk adjustment reimbursement methodologies and policies to ensure the accuracy and integrity of risk adjustment data submitted to the Centers for Medicare & Medicaid Services (CMS) and the Department of Health Services (DHS).
Qualifications
- Bachelor’s degree required with an emphasis in a business or medical field, or a registered nurse degree.
- Completion of courses in Current Procedural Terminology (CPT), and ICD-9, ICD-10 and Hierarchical Condition Category (HCC) coding required.
- Will consider years of experience in lieu of bachelor's degree.
- Three years’ experience required in a health insurance, nursing, compliance, or auditing related position.
- Demonstrated knowledge of anatomy/physiology, medical terminology, Word, Excel, Power Point and Access.
- Adult education/training and curriculum development preferred.
- Certified Professional Coder certification awarded by American Academy of Professional Coders required within one year required.
- State of Wisconsin Registered Nurse license (if applicable).
- Certified Risk Adjustment Coder awarded by American Academy of Professional Coders preferred.
Benefits
Sanford offers an attractive benefits package for qualifying full-time and part-time employees. Depending on eligibility, a variety of benefits include health insurance, dental insurance, vision insurance, life insurance, a 401(k) retirement plan, work/life balance benefits, and a generous time off package to maintain a healthy home-work balance.
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