Revenue Integrity Coding Specialist

🔥 0 minutes ago

🇺🇸 United States – Remote

💵 $27 - $33 / hour

⏰ Full Time

🟡 Mid-level

🟠 Senior

🏥 Medical Billing and Coding

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LifeStance Health

WebsiteLinkedInAll Job Openings

5001 - 10000 employees

💼 Consulting

🛡️ Insurance

🏥 Healthcare

💰 Private Equity Round on 2016-12

Consulting • Insurance • Healthcare

LifeStance Health is a provider of comprehensive mental health services, offering care through in-person and telehealth appointments for various mental health conditions such as anxiety, depression, ADHD, and more. With a large network of licensed clinicians, including psychiatrists, psychologists, and therapists, LifeStance Health tailors care plans to fit individual needs. The company accepts a wide range of insurance plans, making mental health care accessible to a broad audience. Services include therapy, psychiatric evaluations, medication management, and psychological testing across numerous states.

📋 Description

• Support high-value projects aligned with strategic business goals • Improve Days Sales Outstanding (DSO) and denial rate through prompt troubleshooting • Respond to external charge code audits and improve payer audit resolution rates • Solve correctable coding errors to reduce denials and revenue leakage • Research payer reimbursement guidelines and evaluate their impact on coding practices • Use machine learning tools to proactively detect trends monitored by health plans • Identify exceptions and outliers and validate machine learning output through manual review • Use PowerBI and Advanced Excel to identify and confirm trends • Notify state Medical and Clinical Leaders about documentation improvement opportunities • Partner with Revenue Cycle Leaders on upstream intervention and downstream responses to coding-related denials and exclusions • Execute the Coding Informatics Payer Audit Standardization initiative • Liaise between internal departments and external vendors on medical records submission procedures • Monitor payer audit trends and enhance workflows and processes • Maintain departmental documents and procedures • Track the success of payer audits, company performance, and recoupments • Provide monthly scorecards to the Sr Director and communicate progress toward performance objectives • Execute strategies to improve efficiency, customer satisfaction, and operational effectiveness • Identify workflow inefficiencies and implement solutions to improve productivity, quality, and operational efficiency • Report to the Sr. Manager, Revenue Integrity • Participate in projects and initiatives and perform additional responsibilities supporting the team and mission

🎯 Requirements

• Passed a Medical Coding Certificate Exam (CPC, CPC-A, CCS, or CPMA), or at least 4 years’ experience coaching clinical coding and applying clinical coding in a healthcare setting • Proficiency in medical terminology • Advanced knowledge of payer audits, rebuttals, and redeterminations • Medical Coding Certificate (CPC, CPC-A, or CCS) preferred • Comparable certification and/or degree may be considered in lieu of Medical Coding Certification • Advanced Microsoft Excel skills, including heavy use of data analysis • Proficiency in Microsoft Word • Experience with Electronic Medical Records • Experience with Practice Management Software • Knowledge of HIPAA requirements • Knowledge of mental/behavioral health desired • Strong verbal and written communication skills • Flexibility, creativity, and empathy to balance priorities and maintain relationships • Proven ability to lead through organizational change • Ability to navigate unclear or evolving requirements • Proactive problem-solving and initiative • Strong collaboration skills and positive attitude • Active participation in team activities and commitment to a supportive, inclusive work environment • Ability to sit, stand, bend, talk, and hear; walk frequently; and lift or move objects up to 25 pounds

🏖️ Benefits

• Medical, dental, vision, AD&D, short- and long-term disability, and life insurance • 401k retirement savings with employer match • Paid parental leave • Paid time off • Holiday pay • Employee Assistance Program • Weekly team touchpoints • Professional development opportunities • Potential bonus