Risk Adjustment Coder (Remote) - Health Support Center : Job Details

Risk Adjustment Coder

Schedule: M-F. Full time, 40hrs per week. Traditional business hours in your time zone.

Job Location Type: Remote

Your experience matters

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 .

More about our team

Medical Group Revenue Integrity, a company of LifePoint Health, is a rapidly growing 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.

How you'll contribute

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.

A Risk Adjustment Coder who excels in this role:

• Possess subject matter expert in how proper provider documentation drives accurate coding of outpatient ser-vices and associated risk adjustment.

• Analyze patient medical records to identify all relevant diagnoses, including chronic conditions, and ensure they are accurately documented.

• Assigning 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.

• Identifying opportunities to improve clinical documentation and working 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 set-ting and with physician encounters and how physician documentation translates into ICD-10-CM and HCC risk ad-justment for claims submission to meet reporting requirements.

Why join us

We believe that investing in our employees is the first step to providing excellent patient care. In addition to your base compensation, this position also offers:

• Comprehensive Benefits: Multiple levels of medical, dental and vision coverage for full-time and part-time employees.

• Financial Protection & PTO: Life, accident, critical illness, hospital indemnity insurance, short- and long-term disability, paid family leave and paid time off.

• Financial & Career Growth: Higher education and certification tuition assistance, loan assistance and 401(k) retirement package and company match.

• Employee Well-being: Mental, physical, and financial wellness programs (free gym memberships, virtual care appointments, mental health services and discount programs).

• Professional Development: Ongoing learning and career advancement opportunities.

• This position is incentive bonus eligible.

What we're looking for

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

• Experience: A minimum of 3 years of experience in Risk Adjustment Coding and Procedural Coding.

• License or Certification: This position requires an applicable Certified Professional Coder (CPC) and Certified Risk Adjustment Coder (CRC), credentialing through AHIMA, and/or AAPC with three years of ICD-10 and/or CPT/HCPCS coding.

Hourly range: $24.81-31.02 per hour.

EEOC Statement

Lifepoint Health is an Equal Opportunity Employer. Lifepoint Health is committed to Equal Employment Opportunity for all applicants and employees and complies with all applicable laws prohibiting discrimination and harassment in employment.

You must be authorized to work in the United States without employer sponsorship.

Lifepoint Health is a leader in community-based care and driven by a mission of Making Communities Healthier. Our diversified healthcare delivery network spans 29 states and includes 63 community hospital campuses, 32 rehabilitation and behavioral health hospitals, and more than 170 additional sites of care across the healthcare continuum, such as acute rehabilitation units, outpatient centers and post-acute care facilities. 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.