Hybrid Risk Adjustment Coder I – HCC Specialist (IN)

Mosaic Health, LLC.; Indiana, Northern (PA, KY); Hybrid; USD 29,000 - 43,000; Full time

Job summary

Millennium Physician Group in Indiana seeks a Risk Adjustment Coding Specialist I. This hybrid role reviews records for underlying diagnoses, collaborates with clinicians, and ensures compliant documentation and coding across patient care encounters.

The ideal candidate has 1+ year healthcare experience, CPC/CDEO or AHIMA credentials, and is detail-driven with strong communication skills. Travel is minimal and the team emphasizes accuracy and confidentiality.

Qualifications

• High school diploma or GED required.
• 1+ year experience in a payer/healthcare setting.
• Proficient in 10-key, Word and Excel.
• CPC and/or CDEO credentials preferred.
• AAPC or AHIMA credentials or equivalent encouraged.
• Maintains active professional certification and adheres to guidelines.

Responsibilities

• Verify insurance coverage, eligibility and benefits before service.
• Obtain prior authorizations for procedures, meds and services.
• Conduct prospective medical record reviews for clinical indicators.
• Clarify documentation with providers to ensure accurate coding.
• Stay updated on Medicare guidelines, coding rules and reimbursement methods.
• Participate in coding education to promote accuracy and consistency.
• Review patient records for HCC/Risk Adjustment conditions.
• Coordinate referrals and compile periodic reporting.

Skills

Attention to detail

Team player

Ability to work independently

Education

High school Diploma or GED

Tools

10-key

Word

Excel

Job description

Millennium Physician Group in Indiana seeks a Risk Adjustment Coding Specialist I. This hybrid role reviews records for underlying diagnoses, collaborates with clinicians, and ensures compliant documentation and coding across patient care encounters.

The ideal candidate has 1+ year healthcare experience, CPC/CDEO or AHIMA credentials, and is detail-driven with strong communication skills. Travel is minimal and the team emphasizes accuracy and confidentiality.