Risk Adjustment Coding Specialist II

Millennium Healthcare Management Serv LLC; Florida; Híbrido; USD 32.000 - 48.000; Jornada completa

Descripción de la vacante

Millennium Physician Group, a large Florida-based primary care network, seeks a risk adjustment coding reviewer to validate diagnosis coding accuracy through independent clinical record reviews and documentation support. The role supports Medicare risk adjustment initiatives and improves coding integrity within a value-based care framework.

Under moderate supervision, you will abstract codes, analyze trends, and communicate findings to providers and internal stakeholders, contributing to

Formación

• Independent reviews of patient medical records to validate diagnosis coding accuracy.
• Knowledge of ICD-10-CM coding guidelines and Medicare risk adjustment requirements.
• Ability to identify opportunities and gaps in documentation and coding quality.

Responsabilidades

• Conduct independent reviews of patient medical records to validate diagnosis coding accuracy, completeness, and documentation support.
• Abstract and assign diagnosis codes supported by encounter documentation in accordance with ICD-10-CM and Medicare risk adjustment requirements.
• Analyze coding and documentation trends to identify opportunities for improved diagnosis capture and coding accuracy.
• Review provider activity within risk adjustment and coding support tools to identify variances and opportunities for improvement.
• Support retrospective review activities and validation efforts designed to improve coding quality and documentation integrity.
• Communicate coding findings and recommendations to providers and internal stakeholders.
• Participate in project work, operational initiatives, and process improvement activities supporting risk adjustment performance.
• Maintain productivity and quality standards while managing assigned workloads independently.

Descripción del empleo

Job Description Summary

Millennium Physician Group is one of the largest comprehensive primary care practices in Florida, serving communities through a value-based care model focused on improving patient outcomes and enhancing the healthcare experience. As part of Mosaic Health, MPG is committed to delivering coordinated, patient-centered care while partnering with health plans, providers, and community organizations to improve the health of the populations it serves. Performs independent risk adjustment coding reviews to validate diagnosis coding accuracy, completeness, and documentation support. Applies knowledge of ICD-10-CM coding guidelines, HCC methodologies, and Medicare risk adjustment requirements to identify coding opportunities and documentation gaps. Serves as a knowledgeable resource regarding coding practices and supports operational initiatives that improve coding accuracy and risk score integrity.

Work is performed with moderate supervision and requires interpretation of clinical documentation, coding guidelines, and organizational procedures to resolve routine and moderately complex coding issues.

Key Responsibilities

• Conduct independent reviews of patient medical records to validate diagnosis coding accuracy, completeness, and documentation support.
• Abstract and assign diagnosis codes supported by encounter documentation in accordance with ICD-10-CM and Medicare risk adjustment requirements.
• Analyze coding and documentation trends to identify opportunities for improved diagnosis capture and coding accuracy.
• Review provider activity within risk adjustment and coding support tools to identify variances and opportunities for improvement.
• Support retrospective review activities and validation efforts designed to improve coding quality and documentation integrity.
• Communicate coding findings and recommendations to providers and internal stakeholders.
• Participate in project work, operational initiatives, and process improvement activities supporting risk adjustment performance.
• Maintain productivity and quality standards while managing assigned workloads independently.

Compensation Range

Compensation Range: $22.99 to $34.49 The 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.