Risk Adjustment Coding Specialist I

 Posted 14 hours ago
     
0-2 years experience
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AI Summary

The specialist performs coding reviews and decision-making to validate provider documentation for clinical conditions. They are responsible for prospective, concurrent, and retrospective medical record reviews to ensure accurate severity of illness reporting.

Job Description Summary

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Risk Adjustment Coding Specialist - Remote

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How will you make an impact & Requirements

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Formed in 2008 and headquartered in Fort Myers, Florida, with offices in Florida, North Carolina, and Texas, Millennium Physicians Group (MPG) is the largest independent physician group in the state of Florida and one of the largest in 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.

Under the direction of Burden of Illness department leadership, the Risk Adjustment Coding Specialist is responsible for various aspects of decision-making and coding reviews to facilitate, obtain, validate, and reconcile appropriate provider documentation for clinical conditions that accurately reflect the severity of illness and complexity of patient care.

This position is responsible for risk adjustment coding and quality assurance validation for the following programs, including but not limited to:

  • Prospective medical record review
  • Concurrent outpatient claim diagnosis coding
  • Retrospective medical record and provider response reviews

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