2 credentialed coder jobs found

Your Role The Risk Adjustment Compliance Specialist, Principal is responsible for ensuring organizational compliance with laws related to Risk Adjustment across our Marketplace (ACA), Medicaid and Medicare Advantage lines of business. This role involves auditing, monitoring, and evaluating risk adjustment processes, identifying areas of non-compliance, and recommending corrective actions. The Principal collaborates with internal teams and external partners to maintain the integrity of risk adjustment data and supports the development and implementation of compliance programs. Responsibilities Your Work In this role, you will:  Conduct regular audits and reviews of risk adjustment data submissions to ensure compliance with regulatory requirements (e.g., CMS, OIG, HHS). Monitor changes in risk adjustment guidelines, policies, and regulations, and communicate updates to relevant stakeholders. Analyze risk adjustment...

Risk Adjustment Coder, Auditor and Educator Location:   West Palm Beach, FL (On-site/Local — Multi-Site Primary Care Medical Group)   Job Type:   Full-Time   Department:   Coding & Risk Adjustment / Clinical Quality About the Role Our multi-site primary care medical group is seeking an experienced   MRA Coder and Educator   to lead risk adjustment coding education and training across our West Palm Beach–area clinics. This role is central to ensuring accurate, complete, and compliant HCC/risk adjustment documentation and coding practices among our primary care providers and clinical staff. The ideal candidate is both a   coding subject matter expert   and a   skilled communicator and presenter   — someone who can translate complex risk adjustment concepts into clear, actionable training that resonates with busy physicians and site-level management, while building strong, trust-based relationships across the organization. Key Responsibilities...