Risk Adjustment Coding Specialist II

Millennium Healthcare Management Serv LLC; Pennsylvania; Hybrid; USD 33,000 - 50,000; Full time

Benefits offered by this job

Health insurance

401(k) with match

Life insurance

Paid time off

Holidays & EAP

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, assign ICD-10-CM codes, and collaborate with providers to improve risk capture.

The ideal candidate is analytical, self-directed, and committed to maintaining high standards of coding quality and CMS compliance while working in a fast-paced environment.

Qualifications

• Certified coding credential required (CRC, CPC, CCS, RHIT, RHIA, or equivalent).
• 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.

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 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.

Skills

Coding credentials

MRA & HCC coding

ICD-10-CM coding

Medical record abstraction

Audits & quality reviews

CMS regulations & documentation

Analytical skills

Attention to detail

Independent work

Fast-paced adaptability

Tools

VBAT

Job description

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.

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.