Risk Adjustment Coding Accuracy Specialist

Lumeris • Saint Louis, MO

2d

About The Position

At Lumeris, we believe that our greatest achievements are made possible by the talent and commitment of our team members. That's why we are actively seeking talented and collaborative individuals who are passionate about making a difference in the healthcare industry. Join us today as we strive to create a system of care that every doctor wants for their own family and become part of a community that values its people and empowers you to make an impact. 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.

Requirements

• 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)

Nice To Haves

• Associate degree or technical school
• CPC-I or CRC Certifications

Responsibilities

• 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.

Benefits

• Medical, Vision and Dental Plans
• Tax-Advantage Savings Accounts (FSA & HSA)
• Life Insurance and Disability Insurance
• Paid Time Off (PTO, Sick Time, Paid Leave, Volunteer & Wellness Days)
• Employee Assistance Program
• 401k with company match
• Employee Resource Groups
• Employee Discount Program
• Learning and Development Opportunities

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Number of Employees: 501-1,000 employees