Revenue Management Educator - SHP
Security Health Plan serves more than 225,000 people in a 40-county area in northern, western and central Wisconsin. We offer a variety of health insurance options for employer groups, individuals of all ages, and families of various income levels.
The Security Health Plan 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).
Marshfield Clinic Health System is committed to enriching the lives of others through accessible, affordable compassionate healthcare. Successful applicants will listen, serve and put the needs of patients and customers first.
- Bachelor’s degree with an emphasis in a business or medical field, or a registered nurse degree; Bachelor of Science in Nursing
- Completion of courses in Current Procedural Terminology(CPT), and ICD-9, ICD-10 and Hierarchical Condition Category (HCC) coding
- Three years’ experience in a health insurance, nursing, compliance, or auditing related position
- Knowledge of CPT coding rules, ICD-9 and ICD-10 codes, Healthcare Common Procedure Coding System (HCPCS) codes, HCC coding, use of modifiers, documentation guidelines, CMS Policy requirements, and other reimbursement guidelines required
- Must have demonstrated knowledge of anatomy/physiology, medical terminology, Word, Excel, Power Point and Access
- Certified Professional Coder certification awarded by American Academy of Professional Coders required within one year is required.
- State of Wisconsin Registered Nurse license (if applicable).
Preferred/Optional: Adult education/training and curriculum development. Certified Risk Adjustment Coder awarded by American Academy of Professional Coders.
Inquires can be directed to Beth Westlund, Human Resources at firstname.lastname@example.org
Apply directly through:
Or through our Career Center at:
Reference job# MC161925
1000 N Oak Ave.
Marshfield WI 54449
Marshfield Clinic is an Equal Opportunity / Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, or protected veteran status.