Lucet

Medical Billing and Coding

• The role of the Certified Medical Coder is to review and code medical records in their entirety, assigning appropriate ICD-10-CM codes (as defined by ICD-10-CM Guidelines and CMS) from any/all CMS acceptable documents to be used for financial purposes.
• Ensures adherence to Lucet and Departmental Policies and Procedures.
• Demonstrate advanced knowledge of medical coding across multiple specialties or provide subject matter expertise in a critical specialty area.
• Ensure accurate, complete, and compliant assignment of diagnosis codes while maintaining a minimum of 95% coding accuracy and completeness.
• Maintain current knowledge of ICD-10-CM guidelines, HCC risk adjustment models, Medicare reimbursement requirements, and applicable federal regulations.
• Adhere to HIPAA standards and confidentiality requirements while actively participating in training, education programs, and professional development opportunities.
• Utilize multiple systems and tools to research medical records, manage priorities effectively, and meet productivity expectations in a remote work environment.
• Support quality improvement initiatives, respond promptly to communications, attend required meetings, and contribute to process enhancement efforts.

Certified Medical Coder

Recruitment

• The Temporary Talent Acquisition Partner (TA Partner) manages the full-cycle recruitment process to attract, hire, and retain top talent that aligns with our company's culture and business goals.
• This will be achieved through the development of local and national recruiting, employing traditional sourcing strategies and resources as well as developing and implementing new and creative recruiting ideas.
• Lead end-to-end recruitment activities for various openings across corporate, call center, behavioral health and clinical positions, including sourcing, screening, interviewing, selection, offer development, and hiring while ensuring compliance with applicable policies and regulations.
• Partner with hiring managers and business leaders to understand recruiting needs, develop targeted recruiting strategies, and attract top talent.
• Serve as a trusted recruitment advisor by providing guidance on hiring, interviewing, and candidate selection.
• Maintain recruitment data and reporting through the ATS, ensuring compliance with employment laws, regulations, and organizational standards.

Talent Acquisition Partner

Credentialing Coordinator

• Responsible for credentialing behavioral health providers (clinicians and facilities) for inclusion in the Lucet provider network
• Work collaboratively with providers, external agencies, and other team members within Network Operations and management staff to promote timely processing
• Research and verify provider credentials, including licensure, education, insurance coverage, and professional background
• Communicate with external agencies and conduct database searches to validate provider qualifications
• Review provider applications for errors and inconsistencies; follow up to obtain required information
• Maintain accurate provider records in credentialing databases
• Prepare and update provider files for presentation to Credentialing Committee meetings
• Support departmental projects and identify opportunities to improve workflows

Clinician

• The Clinician, CCR delivers behavioral health utilization management by conducting clinical reviews, coordinating care, and partnering with providers and internal teams to ensure medically appropriate treatment, effective discharge planning, and positive member outcomes
• Conduct clinical reviews across all levels of behavioral health care and apply medical necessity criteria to treatment decisions
• Utilize clinical judgment, evidence-based practices, and peer review processes to recommend appropriate levels of care
• Collaborate with members, families, providers, and internal teams to coordinate care and ensure access to appropriate services and resources
• Support discharge planning and continuity of care, including referrals, follow-ups, and connection to community or outpatient services
• Maintain accurate clinical documentation and adhere to health plan requirements, regulatory standards, and utilization management processes
• Contribute to quality outcomes by managing caseloads, participating in clinical rounds, and supporting efficient service delivery within established guidelines

Clinician, CCR

Care Coordinator

• The Care Access Coordinator is a non-clinical support role that ensures efficient access to behavioral health services by combining administrative accuracy, responsive customer support, and effective coordination between members, providers, and clinical teams.
• Process authorizations, enter and audit data, and manage documentation across multiple systems to ensure accuracy and workflow efficiency.
• Support clinical operations through correspondence (letters, faxes) and by maintaining timely, compliant records aligned with productivity standards.
• Serve as a frontline resource by answering benefit, authorization, and referral questions while verifying member information in compliance with HIPAA.
• Deliver high-quality service through empathetic communication, basic screening, and escalation of high-risk or crisis situations to clinical staff.
• Triage cases and route them appropriately to clinical teams, ensuring accurate and timely information flow for care decisions.
• Collect and share key data (e.g., discharge details, provider updates) to support continuity of care and cross-functional collaboration.

Care Access Coordinator

Data Analyst

• The Sr Analyst, Healthcare Data will be a business consultant to the rest of the organization in providing reports and analysis to support Lucet’s clinical and operational performance.
• In addition, the analyst is responsible for translating evaluation questions into analytic plans, constructing analytic datasets, producing appropriate data summaries, and conducting valid data comparisons and statistical tests.
• Lead reporting and analytics initiatives that support product innovation, program evaluation, and population health strategies.
• Partner with clinical, account management, and strategy teams to identify target populations, define intervention cohorts, and develop meaningful performance measures.
• Conduct claims and utilization analyses to identify cost drivers, savings opportunities, and actionable trends across member, provider, and demographic segments.
• Model cost-savings scenarios, evaluate practice patterns, and develop recommendations to improve cost of care and financial outcomes for clients.
• Assess the financial impact of contracts, negotiations, RFPs/RFIs, and other strategic initiatives to support informed decision-making.
• Deliver timely analyses and reporting that help management and operational teams achieve business objectives while ensuring data-driven recommendations.

Senior Healthcare Data Analyst

Advanced Practice Provider

• Deliver comprehensive virtual care, including patient assessments, condition management, medication review, and appropriate escalation, while ensuring compliance with telehealth regulations and licensure requirements.
• Collaborate with multidisciplinary teams and utilize telehealth workflows to support coordinated, continuous care and maintain accurate documentation of patient encounters.
• Educate patients on preventive care, disease management, and healthy lifestyle behaviors to improve outcomes and encourage active participation in their health.
• Provide compassionate, culturally sensitive care while maintaining professionalism, strong communication, and sound clinical judgment in all interactions.
• Adhere to clinical guidelines, regulatory standards, and organizational policies while participating in quality improvement initiatives.
• Ensure accurate, timely documentation, uphold patient privacy, and maintain high standards of safety, ethics, and confidentiality.

Advanced Practice Telehealth Provider – Nurse Practitioner / Physician Assistant

• Provide expert guidance to leaders on clinical hiring strategy, workforce planning, and market-informed decision-making.
• Serve as a clinical recruiting SME, advising on role alignment, licensure, experience, and care delivery needs (with depth in physician, behavioral health and APP recruiting).
• Partner with leadership and stakeholders to shape workforce strategies, compensation approaches, and agency utilization based on market dynamics and growth goals.
• Own and advice external agency strategies and processes for clinical recruiting.
• Lead end-to-end recruitment for complex clinical roles while building strong, sustainable talent pipelines.
• Manage full-cycle recruiting across high-demand clinical roles, driving sourcing, engagement, offer strategy, and successful hiring outcomes in competitive markets.
• Build and maintain proactive pipelines using diverse sourcing strategies, market mapping, and relationship management to support long-term hiring needs.
• Ensure efficient, compliant, and scalable recruiting operations.

Senior Talent Acquisition Partner – Clinical

Data Scientist

• Create strategic solutions from large amounts of data collected from various sources
• Organize and analyze data, interpreting and communicating results to stakeholders
• Perform quantitative analyses and design behavioral health assessments
• Partner with cross-functional teams and external collaborators to design research
• Deliver presentations and produce clear, non-technical reports to communicate results
• Lead and manage data-driven projects, including data cleaning and task delegation
• Identify opportunities to leverage insights for business impact while staying current on data science advancements

Senior Data Scientist

Analyst

• The Revenue Cycle Analyst supports the full revenue cycle continuum, spanning front-end, mid-cycle, and back-end functions, while providing data-driven insights to improve revenue integrity, operational efficiency, and financial performance.
• This role combines hands-on revenue cycle execution with analytics and reporting responsibilities, enabling accurate reimbursement, identifying performance trends, and supporting continuous improvement across billing operations and workflows.
• Managed full revenue cycle processes (insurance verification through A/R follow-up), ensuring accurate, timely claims submission and compliance with payer requirements.
• Resolved denials and billing issues, maintained detailed documentation, and supported high-volume workflows with strong accuracy and adherence to standards.
• Create and manage reports and dashboards, ensuring data accuracy while monitoring KPIs to identify risks and performance issues.
• Analyze financial and operational data (e.g., denials, A/R, payer trends) to uncover root causes and deliver actionable insights for improvement.
• Supported and optimized EHR and billing systems, identifying workflow inefficiencies and implementing process and system improvements.

Revenue Cycle Analyst

Revenue Operations

• The role of the Revenue Cycle and Coding Business Operations Manager supports the strategy, planning, and execution of key operational initiatives across the Revenue Cycle Management and Medical Coding functions.
• This role partners with operational leaders, technology, product, and customer success to optimize how people, process, and technology align to deliver high-quality services that support our broader product portfolio.
• This role requires a strategic thinker with strong analytical and communication skills, operational experience in healthcare services, and the ability to translate business goals into executable plans.
• Drive operational excellence by designing scalable processes, improving efficiency and quality, and maintaining documentation, SOPs, and implementation tracking to support growth and workforce management.
• Optimize operational technology and platforms by monitoring tool performance, identifying gaps, defining requirements, and aligning capabilities with business needs and priorities.
• Drive data-informed decision-making by developing KPIs, dashboards, and analytics, analyzing trends and risks, and providing insights and recommendations to improve performance and outcomes.

Manager, Revenue Cycle and Coding Business Operations

Auditor

• Perform concurrent and retrospective medical coding audits to ensure coding accuracy, regulatory compliance, reimbursement integrity, and documentation quality while providing actionable feedback and collaborating with stakeholders to drive continuous improvement in coding practices and audit outcomes.
• Conduct concurrent and retrospective chart audits to validate coding accuracy, completeness, specificity, and adherence to coding guidelines and regulatory requirements.
• Identify coding errors, compliance risks, and potential fraud, waste, or abuse concerns while maintaining coding integrity and supporting appropriate reimbursement.
• Analyze audit trends, root causes, and error patterns; document findings and utilize reporting tools to support data-driven decision making.
• Lead and support quality improvement initiatives by recommending workflow, process, training, and policy enhancements to improve coding quality and consistency.
• Communicate audit findings effectively and provide constructive coaching and education to coders and internal partners.
• Collaborate with coding leadership, educators, and operational teams to maintain audit consistency, support calibration efforts, and ensure adherence to organizational and regulatory standards.

Auditor, Medical Coding

• The Senior Data Analyst reports to the Director of Program Integrity and plays a key role in supporting the organization’s Fraud, Waste, and Abuse (FWA) program.
• This position is responsible for developing reports, conducting advanced data analysis, and monitoring key indicators to ensure adherence to regulatory standards and internal compliance requirements.
• The role works collaboratively across multiple departments to drive compliance initiatives, enhance data integrity, and improve overall operational efficiency.
• Develop proactive analytics and use advanced data analysis, pattern recognition, and anomaly detection to identify potential FWA activity.
• Analyze complex datasets to uncover trends, compliance risks, and operational issues requiring corrective action.
• Create and maintain reports, dashboards, and visualizations to communicate insights across the organization.
• Support investigators and internal initiatives with data analysis, reporting, case development, and presentations.
• Manage case management systems, ensuring data accuracy, workflow efficiency, and timely updates.
• Track departmental metrics (e.g., case volumes, outcomes, performance) and support operational needs, including travel and additional duties.

Senior Data Analyst

Accountant

• The Senior Accountant role is responsible for assisting in preparing and analyzing the monthly financial statements, reconciliation of balance sheet accounts and assisting with external audit requests.
• Utilizing hands-on accounting experience and an in-depth understanding of accounting principles and company practices, this position performs complex accounting activities and financial analyses.
• The Senior Accountant role will also assist with various finance departmental obligations as needed.
• Manage core accounting processes: track and record prepaid expenses, fixed assets (acquisitions, depreciation, disposals), payroll entries, and related accruals to ensure accurate financial reporting.
• Maintain workforce and compensation-related accounting: manage FTE schedules and evaluate reserves for short- and long-term bonus liabilities.
• Record claims-related journal entries (including IBNR) and support accurate financial reporting.
• Prepare claim reserving and cost analysis schedules, leveraging strong knowledge of reserving models.
• Support monthly close and reporting: prepare financial statements, perform account analysis, complete balance sheet reconciliations, and resolve outstanding items.
• Analyze financial performance and payroll-related costs: evaluate expense and salary fluctuations against prior periods and budget, and communicate insights to senior leadership.
• Adhere to Lucet’s Mission Statement, Core Values, Behaviors, Code of Ethical Business Conduct, and Compliance Program.