Senior Risk Adjustment Coding Specialist II

Mosaic Health, LLC.; Florida; On-site; USD 32,000 - 48,000; Full time

Job summary

Millennium Physician Group in Florida is seeking a Risk Adjustment Coding Specialist II to perform independent reviews of patient records, validate diagnosis coding accuracy, and support Medicare risk adjustment initiatives. You will apply ICD-10-CM guidelines and abstract codes that reflect encounter documentation while identifying gaps for improvement.

The role requires interpreting clinical documentation, following coding guidelines, and communicating findings to physicians and stakeholders

Qualifications

• Review patient records to validate diagnosis coding accuracy.
• Apply ICD-10-CM guidelines and Medicare risk adjustment rules.
• Identify gaps and opportunities to improve coding quality.

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 under 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 to improve coding quality and documentation integrity.
• Communicate 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.

Skills

ICD-10-CM coding

HCC methodologies

Medicare risk adjustment

Documentation review

Communication

Tools

Coding tools

Job description

Millennium Physician Group in Florida is seeking a Risk Adjustment Coding Specialist II to perform independent reviews of patient records, validate diagnosis coding accuracy, and support Medicare risk adjustment initiatives. You will apply ICD-10-CM guidelines and abstract codes that reflect encounter documentation while identifying gaps for improvement.

The role requires interpreting clinical documentation, following coding guidelines, and communicating findings to physicians and stakeholders