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Position:

Risk Adjustment Coding Accuracy Specialist

Position Summary:

Responsible for implementation of initiatives to improve documentation and coding accuracy for Lumeris clients. Regularly reviews provider medical records for accurate and complete documentation and coding. Supports retrospective chart reviews as well as pre-visit planning and post visit coding.

Job Description:

Primary Responsibilities:

Remote Opportunity

• Reviews medical records in support or pre-visit planning and post-visit program for opportunities with complete and accurate documentation and coding

• Identifies chronic conditions for providers to review during patient visits

• Queries providers to ensure complete and accurate documentation and coding after patient visits

• Partners with providers and clinical/administrative staff to enhance understanding of Clinical Documentation Improvement program goals in order to achieve Risk Adjustment strategic goals and initiatives.

• Maintains current subject matter expertise by attending professional meetings, seminars, and related continuing education events.

• Collaborates with internal teams to assure client / project-specific goals are met.

• Reviews project specific documentation and code specificity for validation.

• Supports in oversight (overreads) of coding vendor.

• Responsible for communication, input and findings to support Senior Auditors.

Qualifications:

• Bachelor's degree or equivalent

• 3+ years of ICD-10 outpatient coding and provider query experience or the knowledge, skills, and abilities to succeed in the role

• Strong knowledge of ICD-10-CM Coding Guidelines, E/M, CPT/HCPCS, CMS-HCC risk adjustment model, medical record review project management, encounter data management, and IPM/RADV Medical Record Reviewer Guidance

• Coding certification as CPC

• Demonstrated ability to work cross-functionally within corporate matrix environments

• Effective ability to collaborate and partner on complicated initiatives

• Firm verbal and written communication skills

• Favorable computer skills (i.e. Microsoft Office)

Preferred:

• Associate degree or technical school

• CPC-I or CRC Certifications

Working Conditions

• While performing the duties of this job, the employee works in normal office working conditions.

Disclaimer

• The job description describes the general nature and level of work being performed by people assigned to this job and is not intended to be an exhaustive list of all responsibilities, duties and skills required. The physical activities, demands and working conditions represent those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential job duties and responsibilities.

#LI-Remote

Lumeris is an EEO/AA employer M/F/V/D.

The hiring range for this position is:

$54,800.00-$73,250.00

Factors that may be used to determine your actual pay rate include your specific skills, experience, qualifications, location, and comparison to other employees already in this role. This role may also be eligible for incentive compensation. At Lumeris, we are committed to providing a total rewards package that supports your overall well-being. Our benefits include medical, vision, dental, well-being programs, 401(k) with company matching, life insurance, paid time off including paid leave, and so much more. Learn more by visiting our Careers Page (https://www.lumeris.com/healthcare-consulting-careers/) .

Member Facing Position:

No- Not Member or Patient Facing Position

Location:

Remote, USA

Time Type:

Full time

Lumeris and its partners are committed to protecting our high-risk members & prospects when conducting business in-person. All personnel who interact with at-risk members or prospects are required to have completed, at a minimum, the initial series of an approved COVID-19 vaccine. If this role has been identified as member-facing, proof of vaccination will be required as a condition of employment.

Join Our Growing Team!

Lumeris is bringing common sense back to the business of healthcare by empowering value-based care. We create the partnerships and perspectives that are making healthcare safer, more affordable and more personalized for providers, patients and payers alike.

We were founded on the belief that it should be easier to provide the right care, at the right time, at the right cost. Our model is bringing that belief to life, improving outcomes and empowering financial sustainability along the way.

Why Join Lumeris?

At Lumeris, you will be part of team that is focused on solving the nation’s healthcare problem, and you will be able to contribute to our purpose. Our environment is fast-paced, change-oriented and focused on growth and employee engagement. At Lumeris, we know that talent is best utilized when given the opportunity to succeed. That is why we have removed the boundaries that inhibit success and focus on fostering an environment that allows employees to utilize their talents.