Medicare Risk Adjustment Educator & Auditor

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    "raw": "Fort Worth, TX, 76109",
    "city": "Fort Worth",
    "region": "TX",
    "country": "United States",
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  "inferred_at": "2026-06-06T18:57:58.761Z",
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  "detail": {
    "url": "https://palmmedicalcenters.applytojob.com/apply/jobs/details/QEMmAPduVu?&",
    "heading": "Medicare Risk Adjustment Educator & Auditor",
    "html_title": "JazzHR » Job Listings",
    "canonical_url": "https://palmmedicalcenters.applytojob.com/apply/QEMmAPduVu/Medicare-Risk-Adjustment-Educator-Auditor",
    "description_html": "<span style=\"font-size:12px;\">Palm Primary Care is seeking an <b>MRA Educator & Auditor</b> to join our team.  The MRA Educator & Auditor is an essential member of the Managed Care team helping to ensure the accuracy of our patient’s medical records and claims submissions, impacting patient care, operations, and profitability.<br><br><b>Key Duties & Responsibilities:</b><br><br><span style=\"line-height:107%;\"><span style=\"color:#000000;\">To perform this job successfully, an individual must be able to evaluate, prepare, and present audit results and educational instruction to physicians, coders, and other staff using corporate approved audit and education tools and materials.</span></span></span><ul><li style=\"margin-left:8px;\"><span style=\"font-size:12px;\"><span style=\"line-height:103%;\">Review medical records, including patient medical history, physical exams, physician orders, progress notes, consultation reports, diagnostic reports, operative and pathology reports, medication lists, health plan reports, and discharge summaries, and interprets such documentation to ensure capture of all MRA relevant diagnoses in coordination with the physician.</span></span></li></ul><ul><li style=\"margin-left:8px;\"><span style=\"font-size:12px;\"><span style=\"line-height:103%;\">Perform accurate and compliant coding and documentation audits of pertinent medical records and physician services to identify need for coding education to physicians, coders, and other staff involved in the coding and billing process</span></span></li></ul><ul><li style=\"margin-left:8px;\"><span style=\"font-size:12px;\"><span style=\"line-height:103%;\">Coding reviews include routine and periodic assessment of diagnoses and procedures performed with adherence to established coding guidelines of ICD-10-CM (International Classification of Disease), CPT (Current Procedural Terminology),</span></span></li></ul><ul><li style=\"margin-left:8px;\"><span style=\"font-size:12px;\"><span style=\"line-height:103%;\">Verifies and ensures the accuracy, completeness, specificity, and proper coding based on CMS HCC categories</span></span></li></ul><ul><li style=\"margin-left:8px;\"><span style=\"font-size:12px;\"><span style=\"line-height:103%;\">Performs ongoing analysis of medical charts for proper coding and compliance.</span></span></li></ul><ul><li style=\"margin-left:8px;\"><span style=\"font-size:12px;\"><span style=\"line-height:103%;\">Identifies opportunities for improving individual member risk adjustment score accuracy.</span></span></li></ul><ul><li style=\"margin-left:8px;\"><span style=\"font-size:12px;\"><span style=\"line-height:103%;\">Ensures compliance with all applicable Federal, State and/or County laws and regulations related to coding and documentation guidelines for Risk Adjustment Reviews of medical records.</span></span></li><li style=\"margin-left:8px;\"><span style=\"font-size:12px;\"><span style=\"line-height:103%;\">Provides feedback and training to clinicians and other internal clients on:</span></span></li></ul><ul style=\"list-style-type:circle;\"><li style=\"margin-left:56px;\"><span style=\"font-size:12px;\"><span style=\"line-height:103%;\">Supporting documentation and physician self-coding that do not meet quality standards.</span></span></li></ul><ul style=\"list-style-type:circle;\"><li style=\"margin-left:56px;\"><span style=\"font-size:12px;\"><span style=\"line-height:103%;\">Missed coding opportunities.</span></span></li></ul><ul style=\"list-style-type:circle;\"><li style=\"margin-left:56px;\"><span style=\"font-size:12px;\"><span style=\"line-height:103%;\">Clinical documentation<span style=\"color:#000000;\">.</span></span></span></li></ul><ul><li><span style=\"font-size:12px;\"><span style=\"background:#FFFFFF;\"><span style=\"line-height:103%;\"><span style=\"color:#000000;\">Develops reviews and recommends changes to audit and education documents and templates as needed to enhance the overall auditing and education process.</span></span></span></span></li></ul><ul><li><span style=\"font-size:12px;\"><span style=\"background:#FFFFFF;\"><span style=\"line-height:103%;\"><span style=\"color:#000000;\">Evaluates coding requirements and prepares materials for physicians and their staff prior to coding education instruction sessions in an effective and timely manner.</span></span></span></span></li></ul><ul><li><span style=\"font-size:12px;\"><span style=\"background:#FFFFFF;\"><span style=\"line-height:103%;\"><span style=\"color:#000000;\">Performs miscellaneous compliance audits and company-based audit and education projects as needed or requested by senior Medicare risk adjustment director.</span></span></span></span></li></ul><ul><li><span style=\"font-size:12px;\"><span style=\"background:#FFFFFF;\"><span style=\"line-height:103%;\"><span style=\"color:#000000;\">Participate in audit, education, and coding team meetings to discuss solutions to coding guidance or presentation issues.</span></span></span></span></li></ul><ul><li><span style=\"font-size:12px;\"><span style=\"background:#FFFFFF;\"><span style=\"line-height:103%;\"><span style=\"color:#000000;\">Meets or exceeds required departmental deadlines and goals on a consistent basis.</span></span></span></span></li></ul><ul><li><span style=\"font-size:12px;\"><span style=\"background:#FFFFFF;\"><span style=\"line-height:103%;\"><span style=\"color:#000000;\">Maintains strict confidentiality following HIPAA regulations and Company policy.</span></span></span></span></li></ul><ul><li><span style=\"font-size:12px;\"><span style=\"background:#FFFFFF;\"><span style=\"line-height:103%;\"><span style=\"color:#000000;\">Complies with departmental and company-wide policies and procedures.</span></span></span></span></li></ul><ul><li><span style=\"font-size:12px;\"><span style=\"background:#FFFFFF;\"><span style=\"line-height:103%;\"><span style=\"color:#000000;\">Ability to travel to several sites located in the state of Florida/Texas as needed.</span></span></span></span></li></ul><br><span style=\"font-size:12px;\"><b>Education, Experience & Skills Required:</b></span><ul style=\"margin-bottom:1px;\"><li style=\"margin-bottom:1px;\"><span style=\"font-size:12px;\"><span style=\"color:#000000;\"><span style=\"line-height:107%;\">Minimum 3 years of healthcare experience to include experience in a Managed Care setting.</span></span></span></li><li style=\"margin-bottom:1px;\"><span style=\"font-size:12px;\"><span style=\"color:#000000;\"><span style=\"line-height:107%;\">Certified Professional Coder (<strong>CPC</strong>), Certified Professional Medical Auditor (<strong>CPMA</strong>), Certified Risk Adjustment Coder (<strong>CRC</strong>) required. </span></span></span></li><li style=\"margin-bottom:1px;\"><span style=\"font-size:12px;\"><span style=\"color:#000000;\"><span style=\"line-height:107%;\">Certified Documentation Expert Outpatient (<b>CDEO</b>).</span></span></span></li><li style=\"margin-bottom:1px;\"><span style=\"font-size:12px;\"><span style=\"color:#000000;\"><span style=\"line-height:107%;\"> MRA coding experience required. Strong clinical background preferred.</span></span></span></li><li style=\"margin-bottom:1px;\"><span style=\"font-size:12px;\"><span style=\"color:#000000;\"><span style=\"line-height:107%;\">Proficient of quality improvement standards such as NCQA, HEDIS, CAHPS, HOS and CMS.</span></span></span></li><li style=\"margin-bottom:1px;\"><span style=\"font-size:12px;\"><span style=\"color:#000000;\"><span style=\"line-height:107%;\">Advanced understanding of medical terminology, body systems/anatomy, physiology, and concepts of diseases processes. </span></span></span></li><li style=\"margin-bottom:1px;\"><span style=\"font-size:12px;\"><span style=\"color:#000000;\"><span style=\"line-height:107%;\">Demonstrated competency in setting priorities for a team and overseeing work outputs and timelines.</span></span></span></li></ul><ul style=\"margin-bottom:1px;\"><li><span style=\"font-size:12px;\"><span style=\"color:#000000;\"><span style=\"line-height:103%;\">Excellent listening comprehension, oral communication, and written communication skills and the ability to interact in a positive, tactful, and professional manner.</span></span></span></li><li style=\"margin-bottom:1px;\"><span style=\"font-size:12px;\"><span style=\"color:#000000;\"><span style=\"line-height:107%;\">Ability to use Microsoft Office.</span></span></span></li><li style=\"margin-bottom:1px;\"><span style=\"font-size:12px;\"><span style=\"color:#000000;\"><span style=\"line-height:107%;\">Ability to navigate computers, internet programs, and EMR systems</span></span></span></li><li style=\"margin-bottom:1px;\"><span style=\"font-size:12px;\"><span style=\"color:#000000;\"><span style=\"line-height:107%;\">Ability to multitask and prioritize assignments based on urgency</span></span></span></li><li style=\"margin-bottom:1px;\"><span style=\"font-size:12px;\"><span style=\"color:#000000;\"><span style=\"line-height:107%;\">Ability to work independently with little or no need for assistance.</span></span></span></li><li style=\"margin-bottom:1px;\"><span style=\"font-size:12px;\"><span style=\"color:#000000;\"><span style=\"line-height:107%;\">Bilingual English/Spanish-Fluent in English (preferred).</span></span></span></li></ul><br><span style=\"font-size:12px;\"><b>Salary: </b>Negotiable based on experience<br><br><strong>Work Setting</strong>:  Hybrid<br><br><br>Palm Primary Care is an equal opportunity employer that is committed to diversity and inclusion in the workplace. We prohibit discrimination and harassment of any kind based on race, color, sex, religion, sexual orientation, national origin, disability, genetic information, pregnancy, or any other protected characteristic as outlined by federal, state, or local laws.<br><br>This policy applies to all employment practices within our organization, including hiring, recruiting, promotion, termination, layoff, recall, leave of absence, compensation, benefits, training, and apprenticeship. Palm Primary Care makes hiring decisions based solely on qualifications, merit, and business needs at the time.</span>",
    "description_text": "Palm Primary Care is seeking an  MRA Educator & Auditor  to join our team.  The MRA Educator & Auditor is an essential member of the Managed Care team helping to ensure the accuracy of our patient’s medical records and claims submissions, impacting patient care, operations, and profitability.\n Key Duties & Responsibilities:\n To perform this job successfully, an individual must be able to evaluate, prepare, and present audit results and educational instruction to physicians, coders, and other staff using corporate approved audit and education tools and materials. Review medical records, including patient medical history, physical exams, physician orders, progress notes, consultation reports, diagnostic reports, operative and pathology reports, medication lists, health plan reports, and discharge summaries, and interprets such documentation to ensure capture of all MRA relevant diagnoses in coordination with the physician.\n Perform accurate and compliant coding and documentation audits of pertinent medical records and physician services to identify need for coding education to physicians, coders, and other staff involved in the coding and billing process\n Coding reviews include routine and periodic assessment of diagnoses and procedures performed with adherence to established coding guidelines of ICD-10-CM (International Classification of Disease), CPT (Current Procedural Terminology),\n Verifies and ensures the accuracy, completeness, specificity, and proper coding based on CMS HCC categories\n Performs ongoing analysis of medical charts for proper coding and compliance.\n Identifies opportunities for improving individual member risk adjustment score accuracy.\n Ensures compliance with all applicable Federal, State and/or County laws and regulations related to coding and documentation guidelines for Risk Adjustment Reviews of medical records.\n Provides feedback and training to clinicians and other internal clients on:\n Supporting documentation and physician self-coding that do not meet quality standards.\n Missed coding opportunities.\n Clinical documentation .\n Develops reviews and recommends changes to audit and education documents and templates as needed to enhance the overall auditing and education process.\n Evaluates coding requirements and prepares materials for physicians and their staff prior to coding education instruction sessions in an effective and timely manner.\n Performs miscellaneous compliance audits and company-based audit and education projects as needed or requested by senior Medicare risk adjustment director.\n Participate in audit, education, and coding team meetings to discuss solutions to coding guidance or presentation issues.\n Meets or exceeds required departmental deadlines and goals on a consistent basis.\n Maintains strict confidentiality following HIPAA regulations and Company policy.\n Complies with departmental and company-wide policies and procedures.\n Ability to travel to several sites located in the state of Florida/Texas as needed.\n Education, Experience & Skills Required: Minimum 3 years of healthcare experience to include experience in a Managed Care setting.\n Certified Professional Coder ( CPC ), Certified Professional Medical Auditor ( CPMA ), Certified Risk Adjustment Coder ( CRC ) required.\n Certified Documentation Expert Outpatient ( CDEO ).\n  MRA coding experience required. Strong clinical background preferred.\n Proficient of quality improvement standards such as NCQA, HEDIS, CAHPS, HOS and CMS.\n Advanced understanding of medical terminology, body systems/anatomy, physiology, and concepts of diseases processes.\n Demonstrated competency in setting priorities for a team and overseeing work outputs and timelines.\n Excellent listening comprehension, oral communication, and written communication skills and the ability to interact in a positive, tactful, and professional manner.\n Ability to use Microsoft Office.\n Ability to navigate computers, internet programs, and EMR systems\n Ability to multitask and prioritize assignments based on urgency\n Ability to work independently with little or no need for assistance.\n Bilingual English/Spanish-Fluent in English (preferred).\n Salary: Negotiable based on experience\n Work Setting :  Hybrid\nPalm Primary Care is an equal opportunity employer that is committed to diversity and inclusion in the workplace. We prohibit discrimination and harassment of any kind based on race, color, sex, religion, sexual orientation, national origin, disability, genetic information, pregnancy, or any other protected characteristic as outlined by federal, state, or local laws.\nThis policy applies to all employment practices within our organization, including hiring, recruiting, promotion, termination, layoff, recall, leave of absence, compensation, benefits, training, and apprenticeship. Palm Primary Care makes hiring decisions based solely on qualifications, merit, and business needs at the time.",
    "jsonld_jobposting": {
      "url": "https://palmmedicalcenters.applytojob.com/apply/QEMmAPduVu/Medicare-Risk-Adjustment-Educator-Auditor",
      "@type": "JobPosting",
      "title": "Medicare Risk Adjustment Educator & Auditor",
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      "datePosted": "2026-05-28",
      "description": "<span style=\"font-size:12px;\">Palm Primary Care is seeking an <b>MRA Educator & Auditor</b> to join our team.  The MRA Educator & Auditor is an essential member of the Managed Care team helping to ensure the accuracy of our patient’s medical records and claims submissions, impacting patient care, operations, and profitability.<br><br><b>Key Duties & Responsibilities:</b><br><br><span style=\"line-height:107%;\"><span style=\"color:#000000;\">To perform this job successfully, an individual must be able to evaluate, prepare, and present audit results and educational instruction to physicians, coders, and other staff using corporate approved audit and education tools and materials.</span></span></span><ul><li style=\"margin-left:8px;\"><span style=\"font-size:12px;\"><span style=\"line-height:103%;\">Review medical records, including patient medical history, physical exams, physician orders, progress notes, consultation reports, diagnostic reports, operative and pathology reports, medication lists, health plan reports, and discharge summaries, and interprets such documentation to ensure capture of all MRA relevant diagnoses in coordination with the physician.</span></span></li></ul><ul><li style=\"margin-left:8px;\"><span style=\"font-size:12px;\"><span style=\"line-height:103%;\">Perform accurate and compliant coding and documentation audits of pertinent medical records and physician services to identify need for coding education to physicians, coders, and other staff involved in the coding and billing process</span></span></li></ul><ul><li style=\"margin-left:8px;\"><span style=\"font-size:12px;\"><span style=\"line-height:103%;\">Coding reviews include routine and periodic assessment of diagnoses and procedures performed with adherence to established coding guidelines of ICD-10-CM (International Classification of Disease), CPT (Current Procedural Terminology),</span></span></li></ul><ul><li style=\"margin-left:8px;\"><span style=\"font-size:12px;\"><span style=\"line-height:103%;\">Verifies and ensures the accuracy, completeness, specificity, and proper coding based on CMS HCC categories</span></span></li></ul><ul><li style=\"margin-left:8px;\"><span style=\"font-size:12px;\"><span style=\"line-height:103%;\">Performs ongoing analysis of medical charts for proper coding and compliance.</span></span></li></ul><ul><li style=\"margin-left:8px;\"><span style=\"font-size:12px;\"><span style=\"line-height:103%;\">Identifies opportunities for improving individual member risk adjustment score accuracy.</span></span></li></ul><ul><li style=\"margin-left:8px;\"><span style=\"font-size:12px;\"><span style=\"line-height:103%;\">Ensures compliance with all applicable Federal, State and/or County laws and regulations related to coding and documentation guidelines for Risk Adjustment Reviews of medical records.</span></span></li><li style=\"margin-left:8px;\"><span style=\"font-size:12px;\"><span style=\"line-height:103%;\">Provides feedback and training to clinicians and other internal clients on:</span></span></li></ul><ul style=\"list-style-type:circle;\"><li style=\"margin-left:56px;\"><span style=\"font-size:12px;\"><span style=\"line-height:103%;\">Supporting documentation and physician self-coding that do not meet quality standards.</span></span></li></ul><ul style=\"list-style-type:circle;\"><li style=\"margin-left:56px;\"><span style=\"font-size:12px;\"><span style=\"line-height:103%;\">Missed coding opportunities.</span></span></li></ul><ul style=\"list-style-type:circle;\"><li style=\"margin-left:56px;\"><span style=\"font-size:12px;\"><span style=\"line-height:103%;\">Clinical documentation<span style=\"color:#000000;\">.</span></span></span></li></ul><ul><li><span style=\"font-size:12px;\"><span style=\"background:#FFFFFF;\"><span style=\"line-height:103%;\"><span style=\"color:#000000;\">Develops reviews and recommends changes to audit and education documents and templates as needed to enhance the overall auditing and education process.</span></span></span></span></li></ul><ul><li><span style=\"font-size:12px;\"><span style=\"background:#FFFFFF;\"><span style=\"line-height:103%;\"><span style=\"color:#000000;\">Evaluates coding requirements and prepares materials for physicians and their staff prior to coding education instruction sessions in an effective and timely manner.</span></span></span></span></li></ul><ul><li><span style=\"font-size:12px;\"><span style=\"background:#FFFFFF;\"><span style=\"line-height:103%;\"><span style=\"color:#000000;\">Performs miscellaneous compliance audits and company-based audit and education projects as needed or requested by senior Medicare risk adjustment director.</span></span></span></span></li></ul><ul><li><span style=\"font-size:12px;\"><span style=\"background:#FFFFFF;\"><span style=\"line-height:103%;\"><span style=\"color:#000000;\">Participate in audit, education, and coding team meetings to discuss solutions to coding guidance or presentation issues.</span></span></span></span></li></ul><ul><li><span style=\"font-size:12px;\"><span style=\"background:#FFFFFF;\"><span style=\"line-height:103%;\"><span style=\"color:#000000;\">Meets or exceeds required departmental deadlines and goals on a consistent basis.</span></span></span></span></li></ul><ul><li><span style=\"font-size:12px;\"><span style=\"background:#FFFFFF;\"><span style=\"line-height:103%;\"><span style=\"color:#000000;\">Maintains strict confidentiality following HIPAA regulations and Company policy.</span></span></span></span></li></ul><ul><li><span style=\"font-size:12px;\"><span style=\"background:#FFFFFF;\"><span style=\"line-height:103%;\"><span style=\"color:#000000;\">Complies with departmental and company-wide policies and procedures.</span></span></span></span></li></ul><ul><li><span style=\"font-size:12px;\"><span style=\"background:#FFFFFF;\"><span style=\"line-height:103%;\"><span style=\"color:#000000;\">Ability to travel to several sites located in the state of Florida/Texas as needed.</span></span></span></span></li></ul><br><span style=\"font-size:12px;\"><b>Education, Experience & Skills Required:</b></span><ul style=\"margin-bottom:1px;\"><li style=\"margin-bottom:1px;\"><span style=\"font-size:12px;\"><span style=\"color:#000000;\"><span style=\"line-height:107%;\">Minimum 3 years of healthcare experience to include experience in a Managed Care setting.</span></span></span></li><li style=\"margin-bottom:1px;\"><span style=\"font-size:12px;\"><span style=\"color:#000000;\"><span style=\"line-height:107%;\">Certified Professional Coder (<strong>CPC</strong>), Certified Professional Medical Auditor (<strong>CPMA</strong>), Certified Risk Adjustment Coder (<strong>CRC</strong>) required. </span></span></span></li><li style=\"margin-bottom:1px;\"><span style=\"font-size:12px;\"><span style=\"color:#000000;\"><span style=\"line-height:107%;\">Certified Documentation Expert Outpatient (<b>CDEO</b>).</span></span></span></li><li style=\"margin-bottom:1px;\"><span style=\"font-size:12px;\"><span style=\"color:#000000;\"><span style=\"line-height:107%;\"> MRA coding experience required. Strong clinical background preferred.</span></span></span></li><li style=\"margin-bottom:1px;\"><span style=\"font-size:12px;\"><span style=\"color:#000000;\"><span style=\"line-height:107%;\">Proficient of quality improvement standards such as NCQA, HEDIS, CAHPS, HOS and CMS.</span></span></span></li><li style=\"margin-bottom:1px;\"><span style=\"font-size:12px;\"><span style=\"color:#000000;\"><span style=\"line-height:107%;\">Advanced understanding of medical terminology, body systems/anatomy, physiology, and concepts of diseases processes. </span></span></span></li><li style=\"margin-bottom:1px;\"><span style=\"font-size:12px;\"><span style=\"color:#000000;\"><span style=\"line-height:107%;\">Demonstrated competency in setting priorities for a team and overseeing work outputs and timelines.</span></span></span></li></ul><ul style=\"margin-bottom:1px;\"><li><span style=\"font-size:12px;\"><span style=\"color:#000000;\"><span style=\"line-height:103%;\">Excellent listening comprehension, oral communication, and written communication skills and the ability to interact in a positive, tactful, and professional manner.</span></span></span></li><li style=\"margin-bottom:1px;\"><span style=\"font-size:12px;\"><span style=\"color:#000000;\"><span style=\"line-height:107%;\">Ability to use Microsoft Office.</span></span></span></li><li style=\"margin-bottom:1px;\"><span style=\"font-size:12px;\"><span style=\"color:#000000;\"><span style=\"line-height:107%;\">Ability to navigate computers, internet programs, and EMR systems</span></span></span></li><li style=\"margin-bottom:1px;\"><span style=\"font-size:12px;\"><span style=\"color:#000000;\"><span style=\"line-height:107%;\">Ability to multitask and prioritize assignments based on urgency</span></span></span></li><li style=\"margin-bottom:1px;\"><span style=\"font-size:12px;\"><span style=\"color:#000000;\"><span style=\"line-height:107%;\">Ability to work independently with little or no need for assistance.</span></span></span></li><li style=\"margin-bottom:1px;\"><span style=\"font-size:12px;\"><span style=\"color:#000000;\"><span style=\"line-height:107%;\">Bilingual English/Spanish-Fluent in English (preferred).</span></span></span></li></ul><br><span style=\"font-size:12px;\"><b>Salary: </b>Negotiable based on experience<br><br><strong>Work Setting</strong>:  Hybrid<br><br><br>Palm Primary Care is an equal opportunity employer that is committed to diversity and inclusion in the workplace. We prohibit discrimination and harassment of any kind based on race, color, sex, religion, sexual orientation, national origin, disability, genetic information, pregnancy, or any other protected characteristic as outlined by federal, state, or local laws.<br><br>This policy applies to all employment practices within our organization, including hiring, recruiting, promotion, termination, layoff, recall, leave of absence, compensation, benefits, training, and apprenticeship. Palm Primary Care makes hiring decisions based solely on qualifications, merit, and business needs at the time.</span>",
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          "postalCode": "76109",
          "addressRegion": "TX",
          "addressLocality": "Fort Worth"
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      "validThrough": "2026-08-26",
      "uniqueJobCode": "job_20260528215202_68IVM1RR56UWMP1W",
      "employmentType": "FULL_TIME",
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      "experienceRequirements": "Mid Level"
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    "title": "Medicare Risk Adjustment Educator & Auditor",
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