Job Closed
This listing is no longer active.
Located in Marshfield, Wisconsin, the Marshfield Clinic is a health care system dedicated to providing affordable, accessible, and compassionate care to its com
Revenue Management Educator
Location
United States
Posted
118 days ago
Salary
0
No structured requirement data.
Job Description
Revenue Management Educator
Marshfield Clinic
This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description 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. - Develops and implements strategic action, quality improvement and risk management plans. - Provides overall educational support and coding quality assurance activities to both internal and external stakeholders. - Ensures 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 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. - 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. - Demonstrated knowledge of anatomy/physiology, medical terminology, Word, Excel, Power Point and Access. - Adult education/training and curriculum development (preferred). Requirements - Certified Professional Coder certification awarded by American Academy of Professional Coders required within one year. - State of Wisconsin Registered Nurse license (if applicable). - Certified Risk Adjustment Coder awarded by American Academy of Professional Coders (preferred). Benefits - Marshfield Clinic Health System is committed to enriching the lives of others through accessible, affordable and compassionate healthcare. - Successful applicants will listen, serve and put the needs of patients and customers first.
Job Requirements
- Bachelor’s degree 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.
- 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.
- 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.
- State of Wisconsin Registered Nurse license (if applicable).
- Certified Risk Adjustment Coder awarded by American Academy of Professional Coders (preferred).
Benefits
- Marshfield Clinic Health System is committed to enriching the lives of others through accessible, affordable and compassionate healthcare.
- Successful applicants will listen, serve and put the needs of patients and customers first.
Related Guides
Related Categories
Related Job Pages
More Business Analyst Jobs
• Develop, manage, and enhance KPIs, dashboards, and performance reporting using Power BI, enterprise data sources, and other data systems • Partner with Finance to support functional and business forecasting, financial target setting, functional target setting and planning cycles • Partner with Accounting to support timely global deal processing, recognition and flow across commercial/finance systems • Analyze forecast variances, performance drivers, and trends, providing clear insights and recommendations • Prepare executive-ready analytics and insights to support MBRs, QBRs, and other leadership reviews • Analyze large, complex datasets from ERP and CRM systems to identify risks, opportunities, and optimization areas • Leverage AI, automation, and advanced analytics to streamline reporting, improve forecasting accuracy, and increase analytical efficiency • Translate complex data into clear, actionable insights for senior business stakeholders • Collaborate with global, cross-functional teams to support strategic and operational initiatives
• Support product feature development, system enhancements, and cross-platform integrations across multiple SaaS environments • Elicit, analyze, and document business requirements through stakeholder engagement • Translate business needs into clear functional specifications, user stories, and acceptance criteria • Define user flows, business rules, validation logic, and system behaviors • Document workflows, integrations, and system dependencies • Support data field mapping and API documentation as required • Participate in sprint planning and backlog refinement • Partner with engineering teams to proactively resolve ambiguity prior to development • Maintain organized and version-controlled documentation standards
• Lead requirement discovery sessions with business and technical stakeholders • Translate business needs into clear functional, technical, and solution specifications • Act as a techno-functional bridge between business, design, and engineering teams • Use GenAI tools to assist with: UI ideation and wireframe creation, Spec building and documentation acceleration, Solution exploration and validation • Collaborate with engineering teams to validate feasibility and design scalable solutions • Drive end-to-end solutioning, from requirement gathering to delivery support • Review solutions to ensure alignment with business goals and technical standards • Support pre-sales, solution walkthroughs, and stakeholder presentations when required
• Perform various analysis and interpretation to link business needs and objectives for assigned function • Deliver analytics and reporting for local and national Value Based Care (VBC) provider groups • Leverage corporate Power BI tools to export, analyze, and visualize: Financial performance, Quality outcomes, Risk adjustment metrics and Membership data • Translate data into insights to support corporate leadership, health plan leadership, and provider partners • Identify and analyze user requirements, procedures, and problems to improve existing processes • Perform detailed analysis on multiple projects, recommend potential business solutions and ensure successful implementations • Identify ways to enhance performance management and operational reports related to new business implementation processes • Coordinate with various business units and departments in the development and delivery of training programs • Develop, share, and incorporate organizational best practices into business applications • Diagnose problems and identify opportunities for process redesign and improvement • Formulate and update departmental policies and procedures • Serve as the subject matter expert on the assigned function product to ensure operational performance • Ability to travel • Performs other duties as assigned
