42 certified risk adjustment coder jobs found in Hialeah, FL

Position Responsibilities Demonstrates knowledge of coding and documentation standards as well as CMS risk adjustment guidelines and HCCs (hierarchical condition categories) Reviews medical record to ensure all diagnosis codes are documented for the assignment of a valid and accurate HCC for each episode of care Regularly reviews Epic HCC and payor CSI (Clinically Suspect Conditions) reports Queries and provides feedback and education to physicians when identifying documentation deficiencies to improve accuracy of risk adjustment coding Demonstrates understanding of risk adjustment payment models Uses clinical reasoning and critical thinking skills to discern the financial impact of a query in order to prioritize efforts most efficiently Completes patient medical chart review within 24-48 hours of visit completion Responsible for maintaining active status of coding credentials and completes annual continued education hours. Observes work hours and provides proper notice...

As Mount Sinai grows, so does our legacy in high-quality health care. Since 1949, Mount Sinai Medical Center has remained committed to providing access to its diverse community. In delivering an unmatched level of clinical expertise, our medical center is committed to recruiting and training top healthcare workers from across the country. We offer the latest in advanced medicine, technology, and comfort in 12 facilities across Miami-Dade (including our 674-bed main campus facility) and Monroe Counties, with 38 medical services, including cancer care, 24/7 emergency care, orthopedics, cardiovascular care, and more. Mount Sinai takes pride in being South Florida's largest private independent not-for-profit hospital, dedicated to continuing the training of the next generation of medical pioneers. Culture of Caring: The Sinai Way Our hardworking, tight-knit community of more than 4,000 dedicated employees fosters an environment of care and compassion. Each member plays a vital...

Position ResponsibilitiesDemonstrates knowledge of coding and documentation standards as well as CMS risk adjustment guidelines and HCCs (hierarchical condition categories)Reviews medical record to ensure all diagnosis codes are documented for the assignment of a valid and accurate HCC for each episode of careRegularly reviews Epic HCC and payor CSI (Clinically Suspect Conditions) reportsQueries and provides feedback and education to physicians when identifying documentation deficiencies to improve accuracy of risk adjustment codingDemonstrates understanding of risk adjustment payment modelsUses clinical reasoning and critical thinking skills to discern the financial impact of a query in order to prioritize efforts most efficientlyCompletes patient medical chart review within 24-48 hours of visit completionResponsible for maintaining active status of coding credentials and completes annual continued education hours.Observes work hours and provides proper notice regarding absences...

ClareMedica Health Partners, LLC is seeking an experienced Risk Adjustment Coder to review medical records, identify conditions, and code encounters in alignment with risk adjustment models. The ideal candidate holds CPC certification (CRC preferred), with 3+ years of medical coding experience and strong knowledge of ICD-10-CM and CPT guidelines. Proficiency in EMR and MS Office is required. #J-18808-Ljbffr

Job Description Job Description Porter is hiring a Risk Adjustment Coder to join our Team!   Porter combines the power of analytics with the power of care. Porter is a leading healthcare IT and services platform for care and coverage coordination that optimizes outcomes and member experience. We deliver understanding, compassion, information, and peace of mind for your members. Driven by robust AI analytics, Porter’s Care Guide team helps the member navigate the healthcare delivery system, secures the right support for each member’s specific needs, and directs Porter’s team of expert clinicians to perform comprehensive in-home assessments, complete with lab and diagnostic testing. By coordinating the complexities of each unique care journey, Porter helps close the gaps with the largest impact on quality measures, total cost of care, risk adjustment, and member experience.    Position Overview We are seeking a certified coder with expertise in risk adjustment...

Risk Adjustment CoderPorter is hiring a Risk Adjustment Coder to join our team! Porter combines the power of analytics with the power of care. Porter is a leading healthcare IT and services platform for care and coverage coordination that optimizes outcomes and member experience. We deliver understanding, compassion, information, and peace of mind for your members. Driven by robust AI analytics, Porter's Care Guide team helps the member navigate the healthcare delivery system, secures the right support for each member's specific needs, and directs Porter's team of expert clinicians to perform comprehensive in-home assessments, complete with lab and diagnostic testing. By coordinating the complexities of each unique care journey, Porter helps close the gaps with the largest impact on quality measures, total cost of care, risk adjustment, and member experience.Position OverviewWe are seeking a certified coder with expertise in risk adjustment coding and a specialization in in-home...

Porter is hiring a Risk Adjustment Coder to join our Team! Porter combines the power of analytics with the power of care. Porter is a leading healthcare IT and services platform for care and coverage coordination that optimizes outcomes and member experience. We deliver understanding, compassion, information, and peace of mind for your members. Driven by robust AI analytics, Porter's Care Guide team helps the member navigate the healthcare delivery system, secures the right support for each member's specific needs, and directs Porter's team of expert clinicians to perform comprehensive in-home assessments, complete with lab and diagnostic testing. By coordinating the complexities of each unique care journey, Porter helps close the gaps with the largest impact on quality measures, total cost of care, risk adjustment, and member experience. Position Overview We are seeking a certified coder with expertise in risk adjustment coding and a specialization in in-home health...

Risk Adjustment Coder Porter is hiring a Risk Adjustment Coder to join our team! Porter combines the power of analytics with the power of care. Porter is a leading healthcare IT and services platform for care and coverage coordination that optimizes outcomes and member experience. We deliver understanding, compassion, information, and peace of mind for your members. Driven by robust AI analytics, Porter's Care Guide team helps the member navigate the healthcare delivery system, secures the right support for each member's specific needs, and directs Porter's team of expert clinicians to perform comprehensive in-home assessments, complete with lab and diagnostic testing. By coordinating the complexities of each unique care journey, Porter helps close the gaps with the largest impact on quality measures, total cost of care, risk adjustment, and member experience. Position Overview We are seeking a certified coder with expertise in risk adjustment coding and a specialization in...

Risk Adjustment Coder Porter is hiring a Risk Adjustment Coder to join our team! Porter combines the power of analytics with the power of care. Porter is a leading healthcare IT and services platform for care and coverage coordination that optimizes outcomes and member experience. We deliver understanding, compassion, information, and peace of mind for your members. Driven by robust AI analytics, Porter's Care Guide team helps the member navigate the healthcare delivery system, secures the right support for each member's specific needs, and directs Porter's team of expert clinicians to perform comprehensive in-home assessments, complete with lab and diagnostic testing. By coordinating the complexities of each unique care journey, Porter helps close the gaps with the largest impact on quality measures, total cost of care, risk adjustment, and member experience. Position Overview We are seeking a certified coder with expertise in risk adjustment coding and a specialization in...

Cano Health is seeking a Risk Adjustment Coder to identify and document CMS HCC related diagnoses based on patient encounters. You will review medical records, prepare charts, and ensure coding accuracy with Excel support and coordination with care teams. Ideal candidates have CPC/CPC-A/CCS-P/CRC certification, 2+ years of medical coding experience, and strong attention to detail. Travel to offices may be required to conduct on-site chart reviews and support quality initiatives. #J-18808-Ljbffr

WHO WE ARE NeueHealth is a value-driven healthcare company grounded in the belief that all health consumers are entitled to high-quality, coordinated care. By uniquely aligning the interests of health consumers, providers, and payors, we help to make healthcare accessible and affordable to all populations across the ACA Marketplace, Medicare, and Medicaid. NeueHealth delivers clinical care to health consumers through our owned clinics - Centrum Health and Premier Medical - as well as unique partnerships with affiliated providers across the country. We also enable providers to succeed in performance-based arrangements through a suite of technology and services scaled centrally and deployed locally. Through our value-driven, consumer-centric approach, we are committed to transforming healthcare and creating a better care experience for all. JOB SUMMARY The Coding Coordinator is an integral component of success as it defines and ensures outstanding clinical care for...

City/State Doral, FL Work Shift First (Days) Overview: AvMed, a division of Sentara Health Plans in the Florida market, is hiring a Risk Adjustment Nurse/Coder (RN/CPC, COC, CIC, CCS-P, CCS, RHIT, RHIA in Doral, FL! Status: Full-timepermanent position (40 hours) Standard working hours: 8am to 430pm EST, M-F Location: This is a hybrid position, 2 days onsite in AvMed Doral Office, 3470 NW 82nd Ave Suite 1100, Doral, FL 33122, and 3 days remote. Job Profile Summary Then Risk Adjustment Clinical Coder/Nurse performs compliance activities focused on risk adjustment in accordance with Centers for Medicare & Medicaid Services (CMS) and U.S. Department of Health & Human Services (HHS). Performs prospective/retrospective medical record reviews (MMR) & CMS/HHS Risk Adjustment Data Validation (RADV) audits. Reviews provider coding for professional & inpatient/outpatient services to ensure capture of diagnostic conditions supported within the provider's documentation for...

Cano Health in Miami is seeking a Risk Adjustment Coder to identify, extract and document diagnoses for CMS HCCs. You will review medical records, ensure accuracy of codes and coordinate with PCPs for MRA coding and quality initiatives. The role requires CPC or CCS-P/CPC-A certification and 2 years of medical coding experience, strong Excel skills, attention to detail, and solid communication. Travel to offices for on-site chart reviews may be required. #J-18808-Ljbffr

## Risk Adjustment Coder IIIApply: Hybrid: Miami, FL: Full time: Posted 2 Days Ago: JR4418It's rewarding to be on a team of people that truly believe in making an impact!We are committed to building the best primary care environment for patients and are seeking healthcare enthusiasts to join us.**Job Summary**The Risk Adjustment Coder III is responsible for the accurate and timely assignment of medical diagnosis codes in accordance with established risk adjustment models, coding guidelines, and organizational standards. This role performs high-volume, production-based coding and chart review activities, following defined policies and procedures to ensure compliance and data accuracy. This position applies advanced coding knowledge but operates within established guidelines, with work subject to quality review and audit.**Duties & Responsibilities****Essential Duties & Responsibilities*** **Medical Coding and Documentation*** Assign ICD-10-CM diagnosis codes based on medical...

Cano Health in Miami, FL is seeking a Risk Adjustment Coder III to join our hybrid team. You will assign ICD-10-CM codes, review charts, and ensure accurate HCC capture in line with CMS guidelines. The role requires meticulous documentation and collaboration with clinical staff to support patient care analytics. We expect at least 5 years of medical coding experience with a CPC or CCS certification. Strong analytical and communication skills are essential, and you will participate in audits #J-18808-Ljbffr

It's rewarding to be on a team of people that truly believe in making an impact!We are committed to building the best primary care environment for patients and are seeking healthcare enthusiasts to join us.Job SummaryThe Risk Adjustment coder will identify, collect, assess, monitor and document claims and encounter coding information as it pertains to Clinical Condition Categories. Verify and ensure the accuracy, completeness, specificity, and appropriateness of diagnosis codes based on services rendered. The Risk Adjustment Coder is required to follow procedures and documentation policies regarding claim/encounter information and provide appropriate support to justify their recommendations.Duties & ResponsibilitiesEssential Duties & ResponsibilitiesReview medical record information to identify all appropriate coding based on CMS HCC categoriesPrepare the medical charts and track patient information via Excel spreadsheets.Complete appropriate paperwork/documentation/system...

At Claremedica, exceptional is the standard.Driven by our purpose to enhance the lives of the seniors in the communities where we have the privilege to work, live, and play, the Claremedica team is comprised of the brightest and best in their fields of expertise. From clinical excellence to unparalleled administrative support and beyond, we’re working together to help seniors live happier, healthier, fuller lives.That kind of teamwork and passion for excelling can only exist in a workplace that fosters employees’ growth and wellness and where their full potential and value are realized. At Claremedica, we’re excited about great people like you. We’re even more excited to support you with the resources, training, benefits, competitive compensation, and more to help you thrive and succeed in our communities.Opportunity awaits – welcome to Claremedica.ESSENTIAL FUNCTIONSWe are seeking an accurate, detailed oriented Risk Adjustment Coder to join our team. You will play a key role in...

Job DetailsJob Location: Miami, FL 33126At ClareMedica, exceptional is the standard. Driven by our purpose to enhance the lives of the seniors in the communities where we have the privilege to work, live, and play, the ClareMedica team is comprised of the brightest and best in their fields of expertise. From clinical excellence to unparalleled administrative support and beyond, we’re working together to help seniors live happier, healthier, fuller lives. That kind of teamwork and passion for excelling can only exist in a workplace that fosters employees’ growth and wellness and where their full potential and value are realized. At ClareMedica, we’re excited about great people like you. We’re even more excited to support you with the resources, training, benefits, competitive compensation, and more to help you thrive and succeed in our communities. Opportunity awaits – welcome to ClareMedica. ESSENTIAL FUNCTIONS We are seeking an accurate, detailed oriented Coder to...

Claremedica Health Partners, LLC in Florida seeks an accurate, detail oriented Risk Adjustment Coder to review medical records and encode encounters for Medicare risk adjustment. You will verify charts, ensure coding accuracy and maintain compliance with guidelines. Responsibilities include coding using ICD-10-CM and CPT, identifying chronic/new conditions for validation, and meeting daily production while collaborating with the Sr. Risk Adjustment Manager and coding team. #J-18808-Ljbffr

Coding CoordinatorNeueHealth is a value-driven healthcare company grounded in the belief that all health consumers are entitled to high-quality, coordinated care. By uniquely aligning the interests of health consumers, providers, and payors, we help to make healthcare accessible and affordable to all populations across the ACA Marketplace, Medicare, and Medicaid.NeueHealth delivers clinical care to health consumers through our owned clinics – Centrum Health and Premier Medical – as well as unique partnerships with affiliated providers across the country. We also enable providers to succeed in performance-based arrangements through a suite of technology and services scaled centrally and deployed locally. Through our value-driven, consumer-centric approach, we are committed to transforming healthcare and creating a better care experience for all.The Coding Coordinator is an integral component of success as it defines and ensures outstanding clinical care for members. The Coding...

Medical Coder IIMiami, FL 33126DescriptionAt Claremedica, exceptional is the standard.Driven by our purpose to enhance the lives of the seniors in the communities where we have the privilege to work, live, and play, the Claremedica team is comprised of the brightest and best in their fields of expertise. From clinical excellence to unparalleled administrative support and beyond, we're working together to help seniors live happier, healthier, fuller lives.That kind of teamwork and passion for excelling can only exist in a workplace that fosters employees' growth and wellness and where their full potential and value are realized. At Claremedica, we're excited about great people like you. We're even more excited to support you with the resources, training, benefits, competitive compensation, and more to help you thrive and succeed in our communities.Opportunity awaits – welcome to Claremedica.ESSENTIAL FUNCTIONSWe are seeking an accurate, detailed oriented Risk Adjustment Coder to...

Cano Health is seeking a Risk Adjustment Coder to identify and document CMS HCC related diagnoses based on patient encounters. You will review medical records, prepare charts, and ensure coding accuracy with Excel support and coordination with care teams. Ideal candidates have CPC/CPC-A/CCS-P/CRC certification, 2+ years of medical coding experience, and strong attention to detail. Travel to offices may be required to conduct on-site chart reviews and support quality initiatives. #J-18808-Ljbffr

Medical Coder I At ClareMedica, exceptional is the standard. Driven by our purpose to enhance the lives of the seniors in the communities where we have the privilege to work, live, and play, the ClareMedica team is comprised of the brightest and best in their fields of expertise. From clinical excellence to unparalleled administrative support and beyond, we're working together to help seniors live happier, healthier, fuller lives. That kind of teamwork and passion for excelling can only exist in a workplace that fosters employees' growth and wellness and where their full potential and value are realized. At ClareMedica, we're excited about great people like you. We're even more excited to support you with the resources, training, benefits, competitive compensation, and more to help you thrive and succeed in our communities. Opportunity awaits – welcome to ClareMedica. We are seeking an accurate, detailed oriented Coder to join our team. You will play a key role in reviewing...

Risk Adjustment Coder III It's rewarding to be on a team of people that truly believe in making an impact! We are committed to building the best primary care environment for patients and are seeking healthcare enthusiasts to join us. Job Summary The Risk Adjustment Coder III is responsible for the accurate and timely assignment of medical diagnosis codes in accordance with established risk adjustment models, coding guidelines, and organizational standards. This role performs high-volume, production-based coding and chart review activities, following defined policies and procedures to ensure compliance and data accuracy. This position applies advanced coding knowledge but operates within established guidelines, with work subject to quality review and audit. Duties & Responsibilities Essential Duties & Responsibilities Medical Coding and Documentation Assign ICD-10-CM diagnosis codes based on medical records, clinical documentation, and encounter data in...