Risk Adjustment Coder - Remote Work

Full-time - Mid Level

Remote - Denver, CO

Hospitals

About the position

The Outpatient Risk Adjustment Coder at LifePoint Health is a remote position responsible for ensuring accurate claim submissions by reviewing patient medical records and clarifying at-risk documentation. This role serves as a bridge between providers and coders/billers, focusing on risk adjustment and proper coding for outpatient services. The position emphasizes building strong relationships with clinicians and administrators while delivering educational presentations and tracking case reviews.

Responsibilities

• Review patient medical records to validate accurate representation of severity of illness and risk adjustment.
• Clarify at-risk documentation to ensure accurate claim submission.
• Build strong working relationships with clinicians, administrators, and revenue cycle colleagues.
• Deliver presentations educating physicians and group practices on documentation requirements.
• Track, monitor, and report on case reviews and document results achieved.
• Prioritize and organize time and materials to balance documentation and education needs.

Requirements

• Minimum of an Associate degree in a healthcare related program.
• A minimum of 3 years of experience in health care, business, or finance.
• Applicable CRC, credentialing through AHIMA, and/or AAPC with three years of ICD-10 and/or CPT/HCPCS coding.

Nice-to-haves

• Certified Documentation Expert Outpatient (CDE-O) preferred or obtained within the first eighteen months of employment.
• Knowledge/awareness of HCCs or risk models.
• Ability to navigate in various electronic health records and utilize AI/NLP technologies.

Benefits

• 401k
• Flexible PTO
• Generous Employee Illness Benefit (EIB)
• Medical insurance
• Dental insurance
• Vision insurance
• Tuition reimbursement
• Employee Assistance Program