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Risk Adjustment Coding Specialist II

Millennium Healthcare Management Serv LLC

Abstract and assign ICD-10-CM diagnosis codes supported in encounter documentation while working independently.

Conduct retrospective audits of medical records to validate diagnosis coding accuracy, completeness, and claim submission quality.

Review 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 help develop interventions at the provider or regional level.

Provide written and verbal updates to leadership on project activities and proactively identify project risks.

Requirements & Qualifications

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
  • Strong understanding of ICD-10-CM conventions, documentation standards, and reimbursement systems
  • Proficiency with MS Office, including Excel, Word, Access, and PowerPoint
  • Experience using a variety of electronic medical record systems
  • Ability to manage a significant workload and meet deadlines with minimal supervision
  • Strong organizational, analytical, mathematical, and problem-solving skills
  • Effective written and verbal communication skills
  • Experience contributing to project work, educational development, or group presentations

Location

San Francisco, California, US

Employment Type

Full-time

Experience Level

Intermediate Level

Remote work allowed

No

Posted

3 weeks ago

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