Certified Risk Adjustment Coder
Mount Sinai Medical Center of Florida
## Certified Risk Adjustment CoderApplylocations: Hialeah, FLtime type: Full timeposted on: Posted Todayjob requisition id: JR102682**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 role in our collective mission to deliver excellent healthcare through innovation, education, and research. At Mount Sinai, we take pride in our achievements, aiming to be a beacon of quality healthcare in South Florida. We welcome all healthcare professionals to join our thriving community and contribute to our pursuit for clinical excellence.**Department:****Job Description Summary:**## 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 regarding absences and tardiness* Maintains positive working relationship with Physician Practices, Managed Care and all other departments and communicates with office staff as needed.* Performs other related duties.## Qualifications* ### License/Registration/Certification + CPC, CCS-P or CRC Certification Required* ### Education + High School graduate* ### Experience + Five plus years experience in Coding and Billing, Knowledge of ICD-10-CM and CPT**Benefits:**We believe in the physical and mental well-being of our employees and are committed to offering comprehensive benefits that fit their personal needs:* Health benefits* Life insurance* Long-term disability coverage* Healthcare spending accounts* Retirement plan* Paid time off* Pet Insurance* Tuition reimbursement* Employee assistance program* Wellness program* On-site housing for select positions and more!**Degree Requirements:****Certification:**### About UsMore than 4,000 people work at Mount Sinai Medical Center at more than a dozen locations throughout sunny South Florida, including our flagship, 672-bed hospital on Biscayne Bay at the gateway to Miami Beach. We’re the largest, independent, not-for-profit hospital in South Florida, and we’re the only hospital Healthgrades recognized for four years running as one of the top 5% in the nation. Clearly, clinical excellence is at our core. #J-18808-Ljbffr
- ...Baptist Health is seeking a Certified Professional Coder to perform medical record reviews and coding to support risk adjustment and Medicare compliance. The role involves identifying documentation gaps, communicating with providers, and ensuring accurate ICD-10-CM coding...Risk
- Mount Sinai Medical Center of Florida, Inc. is seeking a Certified Risk Adjustment Coder to ensure accurate coding and documentation standards. The role involves reviewing medical records, providing feedback to physicians, and maintaining coding credentials. The ideal candidate...Risk
- ## Risk Adjustment CoderApplyremote type: Hybridlocations: Jupiter, FLtime type: Full timeposted on: Posted Yesterdayjob requisition id: JR4... ...healthcare enthusiasts to join us.**Job Summary**The Risk Adjustment coder will identify, collect, assess, monitor and document claims...RiskWork at officeFlexible hoursWeekend work
$20.5 - $27.85 per hour
...Required. Certifications/Registration Requirements : CPC (Certified Professional Coder) Preferred or COC (Certified Outpatient Coding)... ...Preferred Additional Requirements CRC (Certified Risk Adjustment Coder) required -or- CIC (Certified Inpatient Coder) required...RiskCasual workRemote work- Oscar Health is hiring an Associate, Risk Adjustment Auditor for their Risk Adjustment team. This remote role requires conducting quality audits specific to ICD-10 code abstraction and ensuring compliance with coding standards. The ideal candidate holds a Bachelor's degree...RiskRemote job
- ...company expertise. Our Crop Division has been helping farmers manage risk since 1915 and is one of the few private companies authorized by... ...part‑time. Hours fluctuate based on seasonal needs. As a Crop Adjuster, You Will Understand and work claims for all major crops, policy...RiskFull timePart timeSeasonal work
$143.62k - $229.79k
Job Description As a Consulting Actuary - ACA Risk Adjustment, you will play a pivotal role in delivering a wide array of actuarial and analytical services for our organization. Responsibilities include leading pricing strategies and actuarial initiatives for business segments...Risk- ...The Senior Clinical Coder serves as a subject matter expert in medical coding and DRG validation... ...systems Escalate complex or high-risk cases to the Medical Director as... ...Active credential in one of the following: Certified Coding Specialist (CCS) Minimum of five...RiskFull timeWork at officeRemote workWork from homeHome office
- ...managing large-scale DoD programs. Must be PMP Certified. Description Oversee program execution,... ...structured reporting mechanisms, risk mitigation strategies, and ongoing program... ...activities, risks, and strategic adjustments. Required Experience Must be PMP certified...RiskContract workTemporary workWork at officeFlexible hours
$75k - $92k
...insurance needs of the wheels‑based transportation industry. We offer risk financing solutions across all 50 states, including traditional... ...and alternative risk transfer programs. Position Workers Comp Adjuster – fully remote (USA) Essential Job Functions And...RiskFull timePart timeSeasonal workRemote work- ...to our world. Job Description Barkera is seeking a Board-Certified Veterinary Nutritionist (DACVIM – Nutrition / ACVN) to join our... ...Geriatric nutrition and cognitive aging Nutritional risk assessment and formulation analysis Raw, fresh, home‑prepared...RiskRemote workFlexible hours
- ...the project lifecycle. Identify project risks and perform proactive risk management to... ...Quality Assurance and Production teams. Adjust cost estimates based on inspection findings... ...structured on‑the‑job training and manufacturer-certified training courses, offering opportunities...RiskWeekly payFull timeContract workWork at office
- ...has been helping generations of farmers take control of their risks since 1915. The Division is also one of a select few private companies... ...farmers and crops. American is currently seeking Seasonal Crop Adjusters. These positions are seasonal and may not be eligible for full-...RiskFull timePart timeSeasonal work
- ...City by identifying potential problems before they occur so that risk‑handling activities may be planned and invoked as needed across... ...License. Special Certifications and Licenses Requires Resident Public Adjuster License. Supplemental Information Physical Demands Physical...RiskFull time
$18.5 - $38.82 per hour
...Medicare and Medicaid Services (CMS) for the purpose of risk adjustment processes are appropriate, accurate, and supported by clinical... ...review, diagnosis coding, and/or auditing. CPC (Certified Professional Coder) or CCS‑P (Certified Coding Specialist‑Physician) required...RiskHourly payFull timeTemporary workWork at officeLocal area- ...defensive cyber operations firm delivering security engineering, risk management, and compliance execution for federal and regulated... ...(Security+) or equivalent (DoD 8570/8140 compliant) Cisco Certified Network Associate (CCNA) or equivalent Clearance Active Top Secret...RiskFull timeWeekend work
- ...package and robust clinical support. Position Highlights Board Certified/Family Nurse Practitioner Active licensure in the state of... ...patients daily Must have experience in Family-Prescribed Medical Risk Adjustment and HEDIS Excellent support from Physicians, Medical...Risk
- ...concern Recommend possible interventions for loss control and risk avoidance based on the outcome of the investigation... ...Associate Degree in Nursing and/or current certification as a Certified Professional Coder (AAPC or AHIMA) Minimum of 4 years related experience Minimum...Risk
- ...efficiency and effectiveness of SIOP processes, making necessary adjustments. Change Management: Drive change initiatives related to SIOP,... ...regularly updated on SIOP activities, milestones, and objectives. Risk Management: Identify potential risks within the SIOP process...Risk
- ...and supplier strategy, resource plan, budget, lessons learned, risk plan, quality plan, safety plan, environmental plan, security plan... ...degree in Business Administration Professional Engineer OR/AND Certified Associate of Project Management OR/AND Project Management...RiskFor contractorsWork experience placement
- ...the smallest builders have access to the tools, capabilities, and risk management options of their largest competitors.**What Sets Us... ...earn engineers’ respect – without necessarily being a hands-on coder.• Demonstrated experience leading or working hand-in-hand with engineering...RiskFor subcontractor
- ...environment focused on continuous improvement and patient satisfaction. Risk Management: Proactively identify and mitigate potential risks... ...Knowledge, Skills, and Abilities Licenses or Certifications Certified Professional in Healthcare Quality (CPHQ) or other relevant...Risk
- ...of equivalent experience in managing DoD projects. Must be PMP certified. Description Manage individual Work Orders, ensuring all milestones... ...schedules and budgets. Track and report on programmatic risks, developing mitigation strategies for potential disruptions in...RiskContract workTemporary workWork at officeFlexible hours
$130k - $160k
...standards, and serve as the primary escalation point for complex, high-risk, or precedent-setting matters. You partner closely with Sales,... ...across federal, state, local, and commercial contracting, adjusting policies and practices accordingly. Drive contracting strategy...RiskContract workH1bLocal areaRemote workVisa sponsorshipWork visa$174.83k - $238.96k
...welcoming culture. The position also serves as the City’s designated risk manager, providing direction on risk- management practices and... ..., and supplies; approves expenditures and implements budgetary adjustments as appropriate and necessary. Facilitates and monitors...RiskWork at officeLocal areaRemote workWeekend workAfternoon shift- Description OVERVIEW The BSA Analyst serves as a consultive and risk management capacity for the BSA Retail function. This role... ...required by this job include close vision, color vision and ability to adjust focus. WORK ENVIRONMENT While performing the duties of this Job...RiskWork experience placementWork at officeLocal area
- ...approved schedules and budgets. Track and report on programmatic risks, developing mitigation strategies for potential disruptions in... ...experience in managing DoD projects. Contractor must be PMP certified. Desirable but not required certifications include Lean Six, Certified...RiskFor contractors
$120k - $165k
...collaborators. Guarantee identification and communication of project risks; develop mitigation plans and guide teams in proactive risk... ...and legal requirements. At its discretion, Baxter may decide to adjust, suspend, or discontinue as business needs change. We understand...RiskTemporary workLocal areaWorldwideWork visaFlexible hours- ...NIST 800-53 Rev. 5, FedRAMP, DoD IL-4/IL-5 security mandates, and Risk Management Framework (RMF) guidelines. The contractor shall... ...compliance analysis. Desirable but not required certifications include Certified Information Systems Auditor (CISA), Certified Information...RiskContract workFor contractors
$20 per hour
A healthcare technology firm based in the United States is seeking a Risk Adjustment Analyst to enhance AI models by evaluating their logic and performance. The ideal candidate will be an expert in healthcare with a strong background in areas like Revenue Cycle Management...RiskRemote jobHourly payFor contractors
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