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Evolent Health Coding Educator in Chicago, Illinois

Evolent Health has a bold mission to change the health of the nation by changing the way health care is delivered. Our pursuit of this mission is the driving power that brings us to work each day. We believe in embracing new ideas, testing ourselves and failing forward. We respect and celebrate individual talents and team wins. We have fun while working hard and Evolenteers often make a difference in everything from scrubs to jeans.

Are we growing? Absolutely. We have seen about 30% average growth over the last three years. Are we recognized? Definitely. We were named one of “Becker’s 150 Great Places to Work in Healthcare” in 2016, 2017, 2018 and 2019 and are proud to be recognized as a leader in driving important Diversity and Inclusion (D&I) efforts: Evolentachieveda 95% score on its first-ever submission to the Human Rights Campaign's Corporate Equality Index; was named on the Best Companies for Women to Advance List 2020 by Parity.org; and we publish an annual Diversity and Inclusion Annual Reporttoshare our progress on how we’re building an equitable workplace. We recognize employees that live our values, give back to our communities each year, and are champions for bringing our whole selves to work each day. If you’re looking for a place where your work can be personally and professionally rewarding, don’t just join a company with a mission. Join a mission with a company behind it.

The Coding Educator, RASQ Strategy will be on the Risk, Adjustment, STARS, Quality (RASQ) team. You’ll be working with our internal RASQ and market teams, clients and providers to oversee the success of risk adjustment efforts for a large Medicaid health plan.

Location: Chicago, IL. Candidate must be in Chicago, or the surrounding area, and be willing to visit provider practices. Evolent is currently working remotely during COVID, but anticipate being back in offices, and visiting provider offices, as safety permits.

What you’ll be doing:

As a key member of our market Risk Adjustment team, you will contribute to the overall success of risk adjustment activities and lead provider education efforts. You will conduct provider & office staff training related to the ICD-10-CM code set, risk adjustment, clinical documentation, and billing functions. You’ll use a combination of data and chart reviews identify patterns in provider coding, then create and deliver targeted education to improve individual coding behaviors.

Responsibilities:

  • Develop relationships with providers and communicate coding and documentation guidelines to ensure correct coding, billing and documentation

  • Conduct chart reviews for providers and review provider performance

  • Analyze coding and billing data to determine provider education needs

  • Provide formal training to providers and staff regarding coding, billing and documentation standards

  • Assist with research, analysis and response to inquiries regarding compliance, coding, and inappropriate coding

  • Perform the minimum number of coding quality reviews consistent with established departmental goals

  • Ensure knowledge of current coding guidelines and relevant federal regulations

Qualifications:

Required

  • Associate’s Degree in Health Information, Health Administration, or other relevant health field

  • Local Chicago area travel, up to 75% of the time.

  • 3-5 years of relevant coding experience

  • A high-level of coding expertise in the following areas and/or disciplines: Risk Adjustment/HCC Coding, Auditing, Outpatient coding

  • Full understanding of regulatory requirements for ICD-10-CM Coding Guidelines, medical record documentation, as well as Medical Staff Rules and Regulations where applicable

  • Knowledge of medical terminology, anatomy and physiology, and disease pathology

  • Exceptional interpersonal skills and ability to develop successful relationships with both internal and external partners

  • Strong presentation skills and ability to communicate highly technical details to non-technical audiences

  • Microsoft Office skills (e.g., Word, Excel, PowerPoint)

  • Strong listening skills, critical thinking, and ability to earn providers’ trust

  • Ability to work in a highly matrixed environment

  • Skills to multitask, prioritize, adapt to change and work well under pressure

Preferred

  • Bachelor’s Degree

  • Certified Risk Adjustment Coder (CRC) credential or similar specialty credential

  • Previous training/teaching experience and customer service education experience preferred

  • Creativity and knowledge of adult learning principals preferred

Technical requirements:

During the current pandemic Evolent employees are working remotely from home. As such we require that all employees have the following technical capability at their home: High speed internet over 10 MBPS and, specifically for all call center employees, the ability to plug in directly to the home internet router. These at-home technical requirements are subject to change with any scheduled re-opening of our office locations.

Evolent Health is an equal opportunity employer and considers all qualified applicants equally without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran status, or disability status.

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