Lumeris

Lumeris.

  • Lakewood, CO


  • Irreversible.

  • Full-time.

In order to make an application for a position at Lumeris, you need to develop an account utilizing your e-mail address and a password of your picking. This account will enable you to get alerts each action of the method through the task application procedure. With these updates, you’ll never ever need to question where you remain in the procedure. Furthermore, we can quickly send out essential files to you for your evaluation. When you develop the account, you might use to any position you feel is an excellent fit without needing to return to info. Thank you for your interest in Lumeris.

Position: Danger Modification Coding Supervisor (REMOTE NATIONWIDE)

Position Summary: The picked prospect will be an essential gamer in the continuing advancement of Lumeris Threat Solutions Coding, Supplier Coding Programs, Company Feedback, & Interdepartmental work. The prospect will contribute in creating relationships to support the viewpoint of total and precise coding and paperwork to guarantee Medicare compliance and optimum information generation. This prospect will work with Suppliers, Customers, & Inter-departmental personnel in relation to the location of Danger Change.

The prospect will play an essential function in making sure performance, precision, & many of all, compliance to CMS Policy as it associates with Coding & Paperwork for the functions of Threat Modification. The position will likewise support existing auditing functions by helping in the advancement of suitable company questions, policy/procedures, and will support the personnel in helping with the shipment of coding-focused education to service providers and health insurance as might be needed. Prospects will help designated Lumeris groups in dealing with company populations to close Persistent Illness Spaces in Care and other specified program objectives. This function needs a self-starter, with the capability to lead & affect operations within and throughout groups.

Task Description:

Functions and Obligations

  • Teams up with coding personnel & suppliers to establish pertinent coding assistance to the service provider population constant with recognized coding authorities and in compliance with appropriate federal assistance
  • Accountable for internal evaluation and coding of medical records and management of unique programs and external suppliers connected to the Medicare danger modification program
  • Establish and preserve HCC thorough check out evaluation program to make sure appropriate paperwork of medical diagnoses, and recognition of medical diagnoses with feedback to Companies.
  • Accountable for reacting to and supervising CMS Threat Change Data Recognition (RADV), and OIG audit demands
  • Coordinate with Compliance Department to develop RADV audit procedure and RADV Audit reactions in ensuring company coding and paperwork compliance with Federal and State regulative bodies
  • Establishes and updates department’s policies and treatments according to recognized workflows
  • Help with the advancement, execution, and oversight of auditing tasks
  • Guarantee auditing/coding production is being fulfilled to please Lumeris/client requirements and legal requirements
  • Collaborate and help with RAS Supervisor( s) and National Teacher with the preparation of information and reports to examine the efficiency and total effect of the scientific paperwork enhancement program for discussion to the Coding and Documents Steering Committee and other proper oversight committees.
  • Supply coding assistance as required within the company (e.g. claims, appeals, case management)
  • Interacts determined chances to particular companies and/or proper internal personnel to assist in action steps
  • Entrusted with moving coding functions from “transactional” to “actionable” to drive precise outcomes
  • Informs members of the client care group, consisting of medical personnel, on documents standards on an on-going basis as required
  • Helps with proper adjustments to scientific paperwork to precisely show client seriousness of disease and danger through substantial interaction with suppliers, care management and nursing personnel, other care providers and the coding personnel
  • Evaluations information and patterns to determine extra locations of chance and to close spaces recognized by means of information produced by Analytics
  • Provides provider-specific metrics and coaches’ companies on Gap-closing chances as required
  • Preserves understanding of coding guidelines and program guidelines to guarantee the paperwork in the client record precisely shows all components affecting the client threat score therefore adding to a certified client record

Experience, Certifications and Education:

Needed:

  • Bachelor’s degree (or higher/equivalent)
  • Qualifications to consist of 2 or a mix of the following: RHIA, RHIT, CCS and/or CPC, CRC, CCDS/CCDS-O, CDIP
  • Understanding of CPT, ICD-9, ICD-10, HEDIS, Medicare services and compensation approaches, RBRVS
  • Substantial understanding of Medicare and CMS Threat Change payment guidelines, guidelines and standards as it associates with handled care companies needed
  • Capability to lead tasks, efforts, or groups as required to accomplish precise & total paperwork for the health insurance & health system customers
  • Pertinent Coding/Auditing Experience, particularly with some management experience in the location
  • Capability to present efficiently to customers & companies; strong capability to affect
  • An enthusiasm for outcomes & a strong sense of ownership of the outcomes

Preferred:

  • CRC (Qualified Danger Coder) credential or obtain within one year of work
  • Minimum 3 years of threat change coding experience; minimum of 3 years’ experience monitoring danger change personnel and programs
  • Experience with IMPRESSIVE and/or Cerner EMR
  • Health Insurance and/or Health System Experience

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

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Time Type: Full-time.

Lumeris.

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