Risk Adjustment Coding Specialist II

Millennium Physician Group; Town of Florida (NY); On-site; USD 32,000 - 47,000; Full time

Job summary

Millennium Physician Group seeks a Level II Risk Adjustment Coding Specialist to abstract ICD-10-CM codes from encounter documentation, conduct audits, and contribute to VBAT and MRA analyses in New York.

The role requires 2+ years of coding experience, including 1 year of HCC coding, and strong knowledge of ICD-10-CM conventions, with proficiency in MS Office and EMR systems. You will collaborate with leadership to meet accuracy and productivity targets.

Qualifications

• Minimum 2 years of coding or related medical experience, including 1 year of HCC coding.
• Advanced knowledge of medical terminology, anatomy, physiology, and disease processes.
• Extensive understanding of ICD-10-CM conventions, documentation standards, and reimbursement systems.
• Strong technical skills, including proficiency with MS Office (Excel, Word, Access, PowerPoint).
• Demonstrated ability to use a variety of electronic medical record systems.
• Ability to manage a significant workload and meet deadlines with minimal supervision.

Responsibilities

• Abstract and assign ICD-10-CM diagnosis codes supported in encounter documentation.
• Conduct retrospective audits of medical records to validate coding accuracy, completeness, and claim submission quality.
• Perform comprehensive reviews of provider actions within the Value-Based Alert Tool (VBAT) to identify outliers and improvement opportunities.
• Analyze Medicare Risk Adjustment (MRA) data to identify coding or documentation patterns and assist in developing interventions at the provider or regional level.
• Keep leadership aware of project activities through written and oral updates; proactively identify project risks.
• Consistently meet or exceed accuracy and productivity benchmarks.
• May be assigned additional projects or a higher workload volume than a Level I specialist.

Skills

ICD-10-CM coding

Medical terminology

Documentation standards

Time management

Data analysis

Tools

MS Office

EMR systems

Job description

Job Description SummaryResponsibilities• Abstract and assign ICD 10 CM diagnosis codes supported in encounter documentation and work independently with minimal oversight from leadership or higher level coders.• Conduct retrospective audits of medical records to validate diagnosis coding accuracy, completeness, and claim submission quality.• Perform comprehensive reviews of provider actions within the Value Based Alert Tool (VBAT) to identify outliers and improvement opportunities.• Analyze Medicare Risk Adjustment (MRA) data to identify coding or documentation patterns and assist in developing interventions at the provider or regional level.• Keep leadership aware of project activities through written and oral updates; proactively identify project risks.• Consistently meet or exceed accuracy and productivity benchmarks.• May be assigned additional projects or a higher workload volume than a Level I specialist.How will you make an impact & RequirementsLEVEL II – RISK ADJUSTMENT CODING SPECIALIST (Intermediate)(Includes all Level I responsibilities + the following)ResponsibilitiesAbstract and assign ICD‑10‑CM diagnosis codes supported in encounter documentation and work independently with minimal oversight from leadership or higher‑level coders.Conduct retrospective audits of medical records to validate diagnosis coding accuracy, completeness, and claim submission quality.Perform comprehensive reviews of provider actions within the Value‑Based Alert Tool (VBAT) to identify outliers and improvement opportunities.Analyze Medicare Risk Adjustment (MRA) data to identify coding or documentation patterns and assist in developing interventions at the provider or regional level.Keep leadership aware of project activities through written and oral updates; proactively identify project risks.Consistently meet or exceed accuracy and productivity benchmarks.May be assigned additional projects or a higher workload volume than a Level I specialist.Qualifications(In addition to Level I minimum qualifications)Minimum 2 years of coding or related medical experience, including 1 year of HCC coding.Advanced knowledge of medical terminology, anatomy, physiology, and disease processes.Extensive understanding of ICD‑10‑CM conventions, documentation standards, and reimbursement systems.Strong technical skills, including proficiency with MS Office (Excel, Word, Access, PowerPoint).Demonstrated ability to use a variety of electronic medical record systems.Ability to manage a significant workload and meet deadlines with minimal supervision.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.