Risk Adjustment Coder (Remote)

LifePoint Health • Brentwood, TN

111d • $24 - $31 • Remote

About The Position

At Lifepoint Health, we are committed to empowering and supporting a diverse and determined workforce who can drive quality, scalability, and significant impact across our hospitals and communities. As a member of the Health Support Center (HSC) team, you'll support those that are in our facilities who are interfacing and providing care to our patients and community members to positively impact our mission of making communities healthier. This remote-based position will bridge the gap between the providers, coders, and billers to clarify at-risk documentation to ensure accurate claim submission. You will be accountable for reviewing patient electronic medical records retrospective submissions to validate an accurate representation of the severity of illness, risk adjustment ICD-10-CM /Hierarchical Condition Category (HCC) coding. You will make decisions on which codes should be assigned in each instance.

Requirements

• Minimum of an associate degree in a healthcare related program.
• A minimum of 3 years of experience in Risk Adjustment Coding and Procedural Coding.
• Applicable Certified Professional Coder (CPC) and Certified Risk Adjustment Coder (CRC) credentialing through AHIMA and/or AAPC.
• Three years of ICD-10 and/or CPT/HCPCS coding experience.

Responsibilities

• Possess subject matter expert in how proper provider documentation drives accurate coding of outpatient services and associated risk adjustment.
• Analyze patient medical records to identify all relevant diagnoses, including chronic conditions, and ensure they are accurately documented.
• Assign appropriate ICD-10-CM codes to patient diagnoses based on established coding guidelines and risk adjustment models.
• Ensure that all coding is accurate, complete, and compliant with relevant regulations, including CMS guidelines.
• Identify opportunities to improve clinical documentation and work with providers to clarify ambiguous or incomplete documentation.
• Demonstrate ability to build strong working relationships with Clinicians, Administrators, and Revenue Cycle colleagues.
• Leverage strong communication skills to bridge interrelated concepts, business functions, and processes to deliver results through risk adjustment coding.
• Understand various payment structures, fee schedules, and reimbursement methodologies in the outpatient setting and with physician encounters.

Benefits

• Multiple levels of medical, dental and vision coverage for full-time and part-time employees.
• Life, accident, critical illness, hospital indemnity insurance, short- and long-term disability, paid family leave and paid time off.
• Higher education and certification tuition assistance, loan assistance and 401(k) retirement package and company match.
• Mental, physical, and financial wellness programs (free gym memberships, virtual care appointments, mental health services and discount programs).
• Ongoing learning and career advancement opportunities.
• Incentive bonus eligibility.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Industry: Hospitals
• Education Level: Associate degree