Risk Adjustment Coding Specialist II

Millennium Physician Group; Conshohocken (Montgomery County); On-site; USD 33,000 - 50,000; Full time

Benefits offered by this job

Health Insurance

Dental Insurance

Vision Insurance

401K with match

Life Insurance

Disability (Short & Long-Term)

Paid Time Off

Holidays

Employee Assistance Program

Job summary

Millennium Physician Group is seeking a Medicare Risk Adjustment (MRA) Coding Specialist to analyze coding trends, perform chart reviews, and assign ICD-10-CM codes aligned with CMS guidelines.

The role involves audits, accuracy improvement, and collaboration with providers and operations to optimize risk capture and documentation quality in a fast-paced environment.

Qualifications

• CRC/CPC/CCS/RHIT/RHIA or equivalent credential required.
• Strong knowledge of MRA and HCC coding methodologies.
• Proficient in ICD-10-CM coding and medical record abstraction.
• Experience conducting coding audits and quality reviews.
• Understanding CMS regulations and risk adjustment concepts.
• Excellent analytical and detail-oriented skills.
• Ability to work independently in a fast-paced environment.

Responsibilities

• Analyze MRA data to identify coding and documentation trends.
• Abstract and assign ICD-10-CM codes with supporting documentation.
• Conduct retrospective chart audits to validate accuracy.
• Review VBAT outputs to spot outliers and improvement opportunities.
• Ensure compliance with CMS guidelines and organizational policies.
• Collaborate with providers and leadership to enhance coding performance.

Skills

MRA knowledge

HCC coding methods

ICD-10-CM coding

Medical record abstraction

Coding audits

Education

Certified coding credential

Tools

VBAT

Job description

Job Description SummaryWe are seeking a detail-oriented and experienced Medicare Risk Adjustment (MRA) Coding Specialist to support accurate risk adjustment coding and documentation initiatives. In this role, you will analyze coding and documentation trends, perform retrospective chart reviews and audits, assign ICD-10-CM diagnosis codes, and collaborate with providers and operational teams to improve coding accuracy and risk capture. The ideal candidate is highly analytical, self-directed, and committed to maintaining the highest standards of coding quality and compliance.How will you make an impact & RequirementsKey ResponsibilitiesAnalyze Medicare Risk Adjustment (MRA) data to identify coding, documentation, and performance trends.Assist in developing provider-level and regional interventions to improve documentation quality and risk adjustment outcomes.Abstract and assign accurate ICD-10-CM diagnosis codes supported by encounter documentation.Conduct retrospective medical record audits to validate coding accuracy, documentation completeness, and claim submission quality.Review provider activity utilizing the Value-Based Alert Tool (VBAT) to identify outliers, trends, and opportunities for improvement.Ensure compliance with CMS guidelines, coding standards, and organizational policies.Work independently with minimal supervision while managing multiple priorities and deadlines.Partner with providers, coding teams, and operational leadership to improve coding performance and documentation practices.Consistently meet or exceed established productivity and quality benchmarks.QualificationsCertified coding credential required (CRC, CPC, CCS, RHIT, RHIA, or equivalent preferred).Strong knowledge of Medicare Risk Adjustment (MRA) and HCC coding methodologies.Proficiency in ICD-10-CM coding and medical record abstraction.Experience conducting coding audits and quality reviews.Understanding of CMS regulations, risk adjustment principles, and documentation requirements.Strong analytical, problem-solving, and critical-thinking skills.Excellent attention to detail and organizational abilities.Ability to work independently and effectively in a fast-paced environment.Preferred QualificationsPrevious experience in risk adjustment coding, auditing, or value-based care programs.Experience using VBAT or similar provider performance and alert management tools.Knowledge of provider education and documentation improvement strategies.About Millennium Physician Group:Formed in 2008 and headquartered in Fort Myers, Florida, with offices in Florida, North Carolina, Georgia, and Texas, Millennium Healthcare is one of the largest independent physician groups in the state of Florida and the United States. At Millennium Physician Group, our employees are the foundation of our success. Our promise is to provide you with the tools to do your job successfully, as well as providing a team atmosphere that empowers you to seek better ways to deliver care to our patients and their families. We also promise to care for you as an individual and help you grow in your role.What We Offer:Health, Dental, and Vision Insurance401(K) Retirement Plan with MatchingEmployer-Paid Life Insurance and Short & Long-Term DisabilityPaid Time Off, Floating Holidays, and Paid Major HolidaysEmployee Assistance Program (EAP)How to Apply:ARE YOU READY TO JOIN OUR TEAM? We understand your time is valuable, and that is why we have a very quick and easy application process. If you feel that you are right for this position, please fill out our initial 3-minute, mobile-friendly application so that we can review your information. We look forward to meeting you!Compensation Range:$24.20to$36.30The anticipated base salary range represents the Company's good-faith estimate of the compensation it reasonably expects to pay for this position at the time of posting. Actual compensation will be determined based on factors including experience, skills, qualifications, geographic location, internal equity, and business needs.