Risk Adjustment Coding Specialist II

Job Description Summary

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Abstract and assign ICD‑10‑CM diagnosis codes supported in encounter documentation and work independently.
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.

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How will you make an impact & Requirements

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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.
• Strong organizational, analytical, mathematical, and problem‑solving skills.
• Effective written and verbal communication abilities.
• Experience contributing to project work, educational development, or group presentations.

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Compensation Range:

$22.00

to

$33.00

 

The 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.