Remote Risk Adjustment Coding Specialist II (ICD-10-CM)

Risk Adjustment Coding Specialist II page is loaded## Risk Adjustment Coding Specialist IIremote type: Remote - Full Timelocations: Florida, USAtime type: Full timeposted on: Posted 2 Days Agotime left to apply: End Date: June 19, 2026 (25 days left to apply)job requisition id: M103630**Job Description Summary**LEVEL II - RISK ADJUSTMENT CODING SPECIALIST (Intermediate)(Includes all Level I responsibilities + the following)Responsibilities- Abstract and assign ICD 10 CM diagnosis codes supported in encounter documentation and work independently with minimal oversight from leadership or higher level coders.- Conduct retrospective audits of medical records to validate diagnosis coding accuracy, completeness, and claim submission quality.[HO1.1]- 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.- Consistently meet or exceed accuracy and productivity benchmarks.- May be assigned additional projects or a higher workload volume than a Level I specialist.**How will you make an impact & Requirements**LEVEL II - RISK ADJUSTMENT CODING SPECIALIST (Intermediate)*(Includes all Level I responsibilities + the following)*Responsibilities* Abstract and assign ICD-10-CM diagnosis codes supported in encounter documentation and work independently with minimal oversight from leadership or higher-level coders.* 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.* Consistently meet or exceed accuracy and productivity benchmarks.* May be assigned additional projects or a higher workload volume than a Level I specialist.Qualifications*(In addition to Level I minimum 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.Mosaic Health is a national care delivery platform focused on expanding access to comprehensive primary care for consumers with coverage across Commercial, Individual Exchange, Medicare, and Medicaid health plans. The Business Units which comprise Mosaic Health are multi-payer and serve nearly one million consumers across 19 states, providing them with access to high quality primary care, integrated care teams, personalized navigation, expanded digital access, and specialized services for higher-need populations. Through Mosaic Health, health plans and employers have an even stronger care provider partner that delivers affordability and superior experiences for their members and employees, including value-based primary care capacity integrated with digital patient engagement and navigation. Each of the companies within Mosaic Health provide unique offerings that together promise to improve individuals' health and wellbeing, while helping care providers deliver higher quality care. For more information, please visit Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws.If you require an accommodation for the application or interview process, please let us know and we will work with you to meet your needs. Please contact View email address on click.appcast.io for assistance. #J-18808-Ljbffr Mosaic Health, LLC.