Hybrid Risk Adjustment Coding Specialist I

Millennium Physician Group; Indiana (PA); Hybrid; USD 29,000 - 43,000; Full time

Job summary

Millennium Physician Group is seeking a Risk Adjustment Coding Specialist I for a hybrid role based in Indiana. The candidate will review medical records for potential diagnoses and support clinician reviews, using EHR tools to identify indicators of underlying conditions.

Responsibilities include prior authorizations, collaboration with providers, adherence to Medicare guidelines, and ongoing coding education to ensure compliant and accurate coding across the organization.

Qualifications

• High school diploma or GED required.
• 1+ years in payer or healthcare-related field.
• Proficient in 10-key, Word, and Excel.
• CPC or CRC designation preferred.
• CDEO or AAPC/AHIMA credential or equivalent.
• Maintains active professional certification and adheres to regulatory standards.
• Strong organizational and documentation tracking skills.
• HIPAA and patient confidentiality compliance.

Responsibilities

• Verify patient insurance coverage, eligibility, and benefits before service.
• Obtain prior authorization for procedures, treatments, medications, and services.
• Perform prospective medical record reviews for clinical indicators of underlying diagnoses.
• Collaborate with providers to ensure accurate coding and reporting of diagnoses.
• Stay updated on Medicare guidelines, coding regulations, and reimbursement methods.
• Participate in coding education to promote consistent practices.
• Maintain knowledge of HCC/Risk Adjustment and documentation requirements.
• Coordinate referrals and monitor progress to ensure timely patient care.
• Establish and maintain relationships with physicians, staff, and management.
• Demonstrate guest service excellence to patients and team members.

Skills

Attention to detail

Compliance knowledge

Teamwork

Education

High school Diploma or GED

Tools

10-key

Word

Excel

Job description

Millennium Physician Group is seeking a Risk Adjustment Coding Specialist I for a hybrid role based in Indiana. The candidate will review medical records for potential diagnoses and support clinician reviews, using EHR tools to identify indicators of underlying conditions.

Responsibilities include prior authorizations, collaboration with providers, adherence to Medicare guidelines, and ongoing coding education to ensure compliant and accurate coding across the organization.