Risk Adjustment Coding Accuracy Specialist

Your Future is our Future

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:

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:

• 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.

Pay Transparency:

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. In addition to the base salary, certain roles may qualify for a performance-based incentive and/or equity, with eligibility depending on the position. These rewards are based on a combination of company performance and individual achievements.

The hiring range for this position is:

$54,800.00-$73,250.00

Benefits of working at Lumeris

• 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

• And much more...

Be part of a team that is changing healthcare!

Member Facing Position:

No- Not Member or Patient Facing Position

Location:

St. Louis, MO

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.

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 individual with disabilities to perform the essential job duties and responsibilities.

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