Risk Adjustment Coding Specialist II

Millennium Physician Group; Pennsylvania; On-site; USD 33,000 - 50,000; Full time

Benefits offered by this job

Health Insurance

Dental Insurance

Vision Insurance

401(K) Retirement Plan with Matching

Employer-Paid Life Insurance

Short & Long-Term Disability

Paid Time Off

Paid Major Holidays

Employee Assistance Program

Job summary

Millennium Physician Group is seeking a Medicare Risk Adjustment (MRA) Coding Specialist to support accurate risk adjustment coding and documentation initiatives. You will analyze coding trends, perform retrospective chart reviews, and collaborate with providers to improve coding accuracy and risk capture.

The ideal candidate will be analytical, self-directed, and uphold high standards of coding quality and compliance in a fast-paced healthcare environment.

Qualifications

• Certified coding credential is required; equivalents preferred.
• Strong knowledge of Medicare Risk Adjustment (MRA) and HCC coding methods.
• Proficiency in ICD-10-CM coding and medical record abstraction.
• Experience conducting coding audits and quality reviews.
• Familiarity with CMS regulations and documentation requirements.

Responsibilities

• Analyze MRA data to identify coding, documentation, and performance trends.
• Develop provider-level and regional interventions to improve documentation quality and risk adjustment outcomes.
• Abstract and assign accurate ICD-10-CM codes supported by documentation.
• Conduct retrospective medical record audits to validate coding accuracy and claim quality.
• Review provider activity using VBAT to identify opportunities for improvement.
• Ensure CMS guidelines and organizational policies are followed.

Skills

ICD-10-CM coding

Data analysis

Independent work

Education

CRC/CPC/CCS/RHIT/RHIA credential or equivalent

Tools

VBAT

Job description

Job Description Summary

We 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 & Requirements

Key Responsibilities

• Analyze 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.

Qualifications

• Certified 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 Qualifications

• Previous 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 Insurance
• 401(K) Retirement Plan with Matching
• Employer-Paid Life Insurance and Short & Long-Term Disability
• Paid Time Off, Floating Holidays, and Paid Major Holidays
• Employee Assistance Program (EAP)

Compensation Range

$24.20 to $36.30

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.