The Physician Services Revenue Integrity team at Lifepoint Health is a nationwide revenue cycle management services provider that has been offering high quality medical billing services since 2004. We offer a rewarding work environment with career advancement opportunities while maintaining a small company, employee-focused atmosphere.

This is a fully remote position! You must live in the United States.

We believe that success is achieved through talented people. We want to create places where employees want to work, with opportunities to pursue meaningful and satisfying careers that truly make a difference in communities across the country.

We are always looking for people inspired to help us in our mission. If you are someone who wants to change the lives of patients, drive success for our partners and be part of a team driven to improve care, we may have your next opportunity.

We are currently seeking an Outpatient Risk Adjustment Coder. This remote-based position will bridge the gap between the providers and coders/billers to clarify at-risk documentation to ensure accurate claim submission. You will be accountable for reviewing patient medical records prior to submission to validate an accurate representation of the severity of illness, risk adjustment and facilitate proper coding. This role will focus on the attributed patients in the AdvantagePoint Health Alliance clinically integrated networks by performing pre-bill review.

ESSENTIAL FUNCTIONS: To perform this job, an individual must perform each essential function satisfactorily with or without a reasonable accommodation.

• Possess subject matter expert in how proper provider documentation drives accurate coding of outpatient services and associated risk adjustment.
• 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 an Outpatient CDI program.
• Understand various payment structures, fee schedules, and reimbursement methodologies in the outpatient setting and with physician encounters and how physician documentation translates into ICD-10-CM and HCC risk adjustment for claims submission to meet reporting requirements.
• Deliver presentations educating physicians, group practices and administration.
• Track, monitor, and report on case reviews/queries and document results achieved.
• Prioritize and organize time and materials, balancing physician documentation and education needs with competing priorities and deadlines.
  

KNOWLEDGE, SKILLS & ABILITIES: The requirements listed below are representative of the knowledge, skills and/or abilities required.

Education: This position requires a minimum of an Associate degree in a healthcare related program

Experience: A minimum of 3 years of experience in health care, business, or finance

License or Certification:

This position requires an applicable CRC, credentialing through AHIMA, and/or AAPC with three years of ICD-10 and/or CPT/HCPCS coding. Certified Documentation Expert Outpatient (CDE-O) preferred or obtained within the first eighteen months of employment.

Skills and Abilities:

This position requires an understanding and knowledge of physician documentation requirements in a clinic setting to capture patients’ acute and chronic conditions

• ICD-10-CM Dx Coding experience
• Ability to work with physicians and providers
• Disciplined – ability to work on their own for the most part after training
• Knowledge/awareness of HCCs or risk models
• Ability to navigate in various electronic health records and utilize AI/NLP technologies
• Positive attitude and team player

PHYSICAL AND MENTAL DEMANDS:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential job responsibilities.

While performing the duties of this job, the employee is occasionally required to stand; walk; sit for extended periods of time; use hands to finger, handle, or feel objects, tools or controls; reach with hands and arms; climb stairs; balance; stoop, kneel, bend, crouch or crawl; talk or hear; taste or smell. The employee must occasionally lift and/or move up to 20 pounds. Repetitive motion of upper body required for extended use of computer. Required specific vision abilities include close vision, distance vision, color vision, peripheral vision, depth perception, and the ability to adjust focus.

Benefits

Pay range: $28-$31/hr. The final agreed upon compensation is based on individual education, qualifications, experience, and work location. This position is bonus eligible.

Lifepoint Health is committed to providing Equal Employment Opportunities for all applicants and employees and complies with all applicable laws prohibiting discrimination against any employee or applicant for employment because of color, race, sex, age, religion, national origin, disability, genetic information, gender identity, sexual orientation, veterans' status or any other basis protected by applicable federal, state or local law.