08/06/2022

Risk Adjustment Coding Educator - Dallas TX

  • UnitedHealth Group
  • Arlington, TX, United States
Full Time

Job Description

Do you have compassion and a passion to help others? Transforming healthcare and millions of lives as a result starts with the values you embrace and the passion you bring to achieve your life’s best work.(sm)

The Risk Adjustment Coding Educator supports the DataRAP Department by providing risk adjustment ICD-10 coding and documentation training to Clinicians utilizing CMS guidelines.  This position is also responsible for training office staff on DataRAP processes, such as Attestations and Focus on Care. The Risk Adjustment Coding Educator is embedded in a clinic to provide onsite instruction by meeting with the Providers and staff on a daily basis and is immediately available for any coding or process questions.  This position serves as a SME for DataRAP processes.

This is an in-office position that requires travel within the Dallas-Fort Worth, TX Area. You will receive mileage reimbursement for your business travel up to 100 miles round trip, per day.

Primary Responsibilities:

  • Processes Attestations and progress notes/documentation sent by Providers for validation following CMS guidelines and ICD-10 coding guidelines and enters final results into the DataRAP Application
  • Travel to assigned clinic in increments per Coding Educator Program to provide one on one training on a daily basis
  • Build rapport with assigned Providers and staff quickly to enhance reception of information
  • Review and analyze Provider documentation, with an eye toward compliance with CMS Risk Adjustment guidelines and identify educational opportunities
  • Devise a plan of education for each assigned Provider to address discrepancies or inadequacies identified in documentation
  • Provide in-depth education to Providers and staff on DataRAP Processes, including Attestations, Focus on Care and ePRG
  • Educate support staff on chart prep prior to scheduled office visits
  • Utilize various tools/reports to assess Provider HCC Metrics and identify educational needs
  • Arrange weekly meetings to discuss the past week’s progress, barriers, etc., with pertinent WellMed Team Members and others as needed
  • Complete spreadsheet with chart prep, training checklist and weekly report while in the clinic to share progress with management
  • Demonstrates and supports Solid collaboration skills and alignment with WellMed Team Members, including Physician Business Manager, Sr. Clinical Coding Nurse Consultants and Medical Directors
  • Performs quarterly audits to maintain coding excellence with at least 95% passing rate
  • Maintains and improves knowledge of current coding guidelines and all Risk Adjustment related applications
  • Provides excellent customer service
  • Complies with corporate policies and procedures
  • Performs all other related duties as assigned


You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:

  • Bachelor’s degree in Business or Healthcare Administration or related field required or (3+ years of comparable work experience beyond the required years of experience may be substituted in lieu of a bachelor’s degree)
  • Certified Professional Coder (CPC) from American Academy of Professional Coders
  • 3+ years of minimum coding experience with 2+ years ICD-10 HCC Coding and Documentation
  • Experience providing direct training and education to medical staff and Clinicians
  • Experience with multiple Electronic Medical Record systems
  • Proficiency with Microsoft Office applications, including Word, Excel, Power Point and Outlook
  • Ability to travel (locally and non-locally) as business needs dictate
  • Full COVID-19 vaccination is an essential job function of this role. Candidates located in states that mandate COVID-19 booster doses must also comply with those state requirements. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination, and boosters when applicable, prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation

Preferred Requirements:

  • Experience with Managed Care
  • Certified Risk Adjustment Coder (CRC)
  • Demonstrate ability to interact with medical staff, peers, and internal staff at all levels
  • Solid attention to detail
  • Ability to maintain professionalism and positive attitude at all times
  • Ability to analyze facts and exercise sound judgement when arriving at conclusions
  • Solid interpersonal and presentation skills


To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles and locations require full COVID-19 vaccination, including boosters, as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment

Careers with WellMed. Our focus is simple. We're innovators in preventative health care, striving to change the face of health care for seniors. We're impacting 550,000+ lives, primarily Medicare eligible seniors in Texas and Florida, through primary and multi-specialty clinics, and contracted medical management services. We've joined Optum, part of the UnitedHealth Group family of companies, and our mission is to help the sick become well and to help patients understand and control their health in a lifelong effort at wellness. Our providers and staff are selected for their dedication and focus on preventative, proactive care. For you, that means one incredible team and a singular opportunity to do your life's best work.(sm)

WellMed was founded in 1990 with a vision of being a physician-led company that could change the face of healthcare delivery for seniors. Through the WellMed Care Model, we specialize in helping our patients stay healthy by providing the care they need from doctors who care about them. We partner with multiple Medicare Advantage health plans in Texas and Florida and look forward to continuing growth.


Diversity creates a healthier atmosphere: OptumCare is an Equal Employment Opportunity/Affirmative Action employers and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.


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