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Risk Adjustment Coding Specialist II

Millennium Physician Group

FL

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JOB DETAILS
SKILLS
Analysis Skills, Anatomy, Auditing, Benchmarking, Claims Processing, Communication Skills, Disease, Documentation, Documentation Standards, Electronic Medical Records, ICD-10, International Classification of Diseases (ICD), Leadership, Mathematics, Medical Coding, Medical Record System, Medical Records, Medical Terminology, Medicare, Microsoft Access Database, Microsoft Excel, Microsoft Office, Microsoft PowerPoint, Microsoft Word, Organizational Skills, Physiology, Presentation/Verbal Skills, Problem Solving Skills, Reimbursement, Risk, Risk Analysis, Support Documentation, Time Management, Writing Skills
LOCATION
FL
POSTED
20 days ago

Job Description Summary

LEVEL II - RISK ADJUSTMENT CODING SPECIALIST (Intermediate)

(Includes all Level I responsibilities + the following)

Responsibilities

  • Abstract and assign ICD 10 CM diagnosis codes supported in encounter documentation and work independently with minimal oversight from leadership or higher level coders.
  • Conduct retrospective audits of medical records to validate diagnosis coding accuracy, completeness, and claim submission quality.[HO1.1]
  • Perform comprehensive reviews of provider actions within the Value Based Alert Tool (VBAT) to identify outliers and improvement opportunities.
  • Analyze Medicare Risk Adjustment (MRA) data to identify coding or documentation patterns and assist in developing interventions at the provider or regional level.
  • Keep leadership aware of project activities through written and oral updates; proactively identify project risks.
  • Consistently meet or exceed accuracy and productivity benchmarks.
  • May be assigned additional projects or a higher workload volume than a Level I specialist.

How will you make an impact & Requirements

LEVEL II - RISK ADJUSTMENT CODING SPECIALIST (Intermediate)

(Includes all Level I responsibilities + the following)

Responsibilities

  • Abstract and assign ICD‑10‑CM diagnosis codes supported in encounter documentation and work independently with minimal oversight from leadership or higher‑level coders.
  • Conduct retrospective audits of medical records to validate diagnosis coding accuracy, completeness, and claim submission quality.
  • Perform comprehensive reviews of provider actions within the Value‑Based Alert Tool (VBAT) to identify outliers and improvement opportunities.
  • Analyze Medicare Risk Adjustment (MRA) data to identify coding or documentation patterns and assist in developing interventions at the provider or regional level.
  • Keep leadership aware of project activities through written and oral updates; proactively identify project risks.
  • Consistently meet or exceed accuracy and productivity benchmarks.
  • May be assigned additional projects or a higher workload volume than a Level I specialist.

Qualifications

(In addition to Level I minimum qualifications)

  • Minimum 2 years of coding or related medical experience, including 1 year of HCC coding.
  • Advanced knowledge of medical terminology, anatomy, physiology, and disease processes.
  • Extensive understanding of ICD‑10‑CM conventions, documentation standards, and reimbursement systems.
  • Strong technical skills, including proficiency with MS Office (Excel, Word, Access, PowerPoint).
  • Demonstrated ability to use a variety of electronic medical record systems.
  • Ability to manage a significant workload and meet deadlines with minimal supervision.
  • Strong organizational, analytical, mathematical, and problem‑solving skills.
  • Effective written and verbal communication abilities.
  • Experience contributing to project work, educational development, or group presentations.

About the Company

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Millennium Physician Group