Risk Adjustment Coding Specialist II

Millennium Physician Group; Oregon; Hybrid; USD 32,000 - 48,000; Full time

Job summary

Millennium Physician Group is a leading primary care network delivering value-based care in Florida, focused on improving patient outcomes through coordinated, patient-centered services. This role supports risk adjustment coding reviews and documentation integrity to help optimize risk scores and care quality across the organization.

The successful candidate will analyze medical records, abstract diagnosis codes, and communicate findings to providers and stakeholders while maintaining

Qualifications

• Proficiency in ICD-10-CM coding guidelines and Medicare risk adjustment concepts.
• Ability to abstract and assign ICD-10-CM diagnosis codes from encounter data.
• Experience analyzing coding trends to identify opportunities for improvement.

Responsibilities

• Perform independent reviews of patient records to validate diagnosis coding accuracy and documentation support.
• Abstract and assign codes in line with ICD-10-CM and Medicare risk adjustment requirements.
• Analyze coding trends to identify opportunities for improved capture and accuracy.
• Review activity within risk adjustment and coding tools to identify variances and improvement opportunities.
• Support retrospective reviews and validation efforts to improve coding quality.
• Communicate findings and recommendations to providers and internal stakeholders.
• Participate in projects and process improvements to enhance risk adjustment performance.
• Maintain productivity and quality while managing workloads independently.

Skills

ICD-10-CM coding

HCC methodologies

Medicare risk adjustment

Job description

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.

Job Description Summary

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.

How will you make an impact & Requirements

• 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: $22.99to $34.49The 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.