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
- ...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...Risk
- ...Job Responsibilities Demonstrates knowledge of coding and documentation standards as well as CMS risk adjustment guidelines and hierarchical condition categories (HCCs). Reviews medical records to ensure all diagnosis codes are documented for valid and accurate HCC assignment...RiskWork at office
- ...remote work. Job Summary The Medicare Coder Specialist facilitates... ...that minimizes any organizational risk in the event of a Risk Adjustment Data Validation (RADV) Audit. Educate... ...Required Licenses and Certifications Certified Professional Coder (CPC) Certified...RiskRemote work
- ...Cano Health, LLC is seeking a Risk Adjustment Coder to join our hybrid team in New York. The coder will identify and document coding information crucial for Clinical Condition Categories and ensure diagnosis code accuracy. This role involves regular collaboration with...Risk
- ...Suvida in the Town of Florida, New York is seeking a Risk Adjustment Coder to enhance documentation and coding accuracy for Medicare-eligible Hispanic seniors. You will coordinate chart reviews and engage with primary care teams to deliver high-quality preventive care....Risk
- ...Suvida Healthcare is seeking a Risk Adjustment Coder to enhance documentation accuracy within primary care for Medicare-eligible seniors in New York. Key responsibilities include reviewing medical records, implementing audit processes, and collaborating with healthcare...Risk
- Suvida Healthcare is seeking a Risk Adjustment Coder to enhance the documentation and coding accuracy for patient care. This position plays a crucial role in supporting the primary care team by conducting thorough reviews of medical records and ensuring compliance with...Risk
- ...Leave Generous Paid Time Off (PTO) 401k Retirement Plan with Company Match And much more What You’ll Do Position Summary The Risk Adjustment Coder will be responsible for coordinating/supporting prospective, retrospective, and concurrent chart reviews using knowledge of...RiskWork at officeLocal area
- ## 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
- ...Job Description SummaryLEVEL II – RISK ADJUSTMENT CODING SPECIALIST (Intermediate)(Includes all Level I responsibilities + the following)... ...independently with minimal oversight from leadership or higher level coders.Conduct retrospective audits of medical records to validate...Risk
- ...Millennium Physician Group is seeking a Level II – Risk Adjustment Coding Specialist in New York. Responsibilities include abstracting ICD-10-CM codes from documentation, auditing medical records for accuracy, and analyzing Medicare Risk Adjustment data. The ideal candidate...Risk
- ...healthcare and creating a better care experience for all. Centrum Health’s Sr. Manager of Risk Adjustment and Quality will be responsible for managing a team of Risk Adjustment Coders, HEDIS specialists, Billers, and Auditors to maintain daily billing and coding...RiskTemporary workWork at office
$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- ...Centrum Health in Doral, FL is seeking a Sr. Manager of Risk Adjustment and Quality to oversee a diverse team responsible for coding, billing, and successful risk adjustment operations. The ideal candidate will have extensive experience in healthcare Risk Adjustment and...Risk
- CVS Health is looking for a Senior Informatics Manager to lead the Risk Adjustment Analytics team in New York. In this role, you will spearhead complex data analyses to enhance health plan performance and manage a small team responsible for delivering advanced analytics...RiskRemote job
- A valued healthcare provider is seeking a Sr. Manager of Risk Adjustment and Quality in New York to lead risk adjustment operations, manage a team, and ensure regulatory compliance. The role requires strong leadership, extensive experience in healthcare risk adjustment,...Risk
- 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
- ...ACCOUNTABILITY ACCURACY (DRG) ACCURACY - CODER ACCURACY - OUTPATIENT ANALYSIS AND... ...School Diploma or Equivalent (Required) Certified Coding Associate (CCA) - American Health... ...Professional Medical Auditor (CPMA), Certified Risk Adjustment Coder (CRC) by AAPC, or Certified...RiskWork experience placementWork at officeLocal areaShift work
- CMP01 Mount Sinai Medical Center of Florida, Inc. seeks an experienced coding professional to ensure accurate HCC assignments through code review and documentation improvement. The ideal candidate will possess a CPC, CCS-P, or CRC certification, and have at least five years...Risk
- ...Blue Cross and Blue Shield of North Carolina is seeking a Senior Data Analyst with expertise in ACA Risk Adjustment and EDGE submissions. This role involves providing complex analytic support, data validation, and collaboration with various stakeholders to ensure timely...RiskRemote work
$67.9k - $199.14k
...community at a time. Position Summary CVS Health has an exciting opportunity for a Senior Informatics Manager to join our dynamic Risk Adjustment Analytics team! In this role, you will lead and execute complex data analyses to drive health plan-level risk adjustment...RiskRemote jobHourly payFull timeTemporary workWork experience placementLocal area- ...The Risk Management Division is actively seeking an All Lines Claims Adjuster. This position reports to the General Liabilities Claims Manager and is responsible for investigating all general liability claims for the City of Jacksonville. Responsibilities Investigate auto...RiskWork at officeLocal areaFlexible hours
- ...driven individual to join our Company as a Certified Roofing Specialist . The rise of... ...occurred and speaking with homeowners about risks and solutions. You will serve as a trusted... ...insurance companies and meeting with adjusters to facilitate the best outcomes possible...RiskFor contractorsFlexible hours
- ...with specialized training and certification in Cancer Genetic Risk Assessment (CGRA) to join our interdisciplinary team. The ideal... ...(MSN) required. Current and unrestricted RN and APN licenses. Certified Family Nurse Practitioner (FNP-C) in good standing. Certification...RiskPart time
$70k - $90k
...global clients to solve their most complex risk management challenges, delivering... ...employees, assets, and reputations. We are a certified Great Place to Work®, and our employee-owners... .... This is a full life‑cycle WC adjuster position within a TPA environment, and only...RiskWork at officeRemote work- The Senior Clinical Coder serves as a subject matter expert in medical coding and DRG validation... ...claims 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
$88k - $120k
...Claims Management Services Ltd is seeking a Construction Defect Adjuster to handle complex third-party bodily injury and property damage... ...advanced expertise in liability determination, coverage analysis, and risk transfer. The ideal candidate will possess a Bachelor's degree...RiskRemote work- ...Orders, ensuring milestones are met while tracking programmatic risks and preparing performance reports. The ideal candidate will... ...degree in Project Management or a related field and must be PMP certified, with an active TS/SCI clearance. Competitive salary and comprehensive...Risk
- ...Namely is seeking an Associate, Risk Adjustment Auditor to join their Risk Adjustment team. This remote role involves conducting internal and external quality audits specific to ICD-10 code abstraction related to accuracy and completeness. Applicants should hold a Bachelor...RiskRemote work
$28.75 per hour
...agencies through radio communications to high‑risk situations, with the objective of keeping... ...applies to applicants who are already certified Public Safety Telecommunicators and are... ...Ability to remain calm, vigilant and able to adjust to rapidly changing situations. Minimum...RiskWork experience placementWork at officeShift work
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