Senior Risk Adjustment QA & Coding Specialist

Millennium Physician Group; Florida; On-site; USD 38,000 - 57,000; Full time

Job summary

Millennium Physician Group seeks an experienced Risk Adjustment Coding Specialist to serve as the most advanced operational resource within the Risk Adjustment Coding function. You will provide expert-level coding support, guidance, and training to coding staff to ensure accurate HCC capture and documentation integrity.

You will lead non-routine issue resolution, review complex records, and drive improvements in workflows, quality, and regulatory readiness while maintaining productivity

Qualifications

• Experience with Medicare risk adjustment coding processes and guidelines.
• Ability to perform advanced medical record reviews for accurate code capture.
• Strong knowledge of ICD-10-CM guidelines and documentation requirements.
• Experience leading coaching and training for coding staff.
• Ability to support audits and regulatory readiness initiatives.

Responsibilities

• Serve as the primary escalation resource for complex coding questions requiring advanced interpretation of coding guidance and regulatory requirements.
• Perform advanced reviews of medical records to validate diagnosis coding accuracy and appropriate HCC capture.
• Lead resolution of non-routine coding issues by researching regulatory guidance and analyzing documentation.
• Act as an indirect team lead by providing day-to-day guidance, training, and knowledge sharing to coding staff.
• Review coding work, provide coaching and feedback, and assist with onboarding and development of new team members.
• Own and support designated coding processes, workflows, tools, or initiatives and recommend improvements.
• Analyze coding, documentation, and provider trends to improve diagnosis capture and compliance.
• Develop and maintain coding resources, job aids, and process documentation.
• Support audits, quality reviews, validation activities, and regulatory readiness initiatives.
• Participate in departmental and cross-functional projects supporting value-based care and risk adjustment outcomes.

Skills

HCC coding

CMS guidelines

Quality coaching

Training leadership

Documentation accuracy

Job description

Millennium Physician Group seeks an experienced Risk Adjustment Coding Specialist to serve as the most advanced operational resource within the Risk Adjustment Coding function. You will provide expert-level coding support, guidance, and training to coding staff to ensure accurate HCC capture and documentation integrity.

You will lead non-routine issue resolution, review complex records, and drive improvements in workflows, quality, and regulatory readiness while maintaining productivity