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 candidate...Risk
- ...experience is preferred. We are seeking an experienced CPC certified medical coder to perform coding audits, utilization reviews, audits and more... ...CMS, LCD/NCD, and payer-specific policies Identify risk areas and compliance vulnerabilities Required Qualifications...RiskTemporary workPart timeRemote 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
- ...support to IPA affiliates nationwide. You will manage a panel of providers, ensure documentation supports accurate coding and risk adjustment, and collaborate with STARS leaders to identify gaps and opportunities. The role involves education delivery, quarterly chart reviews...RiskRemote job
$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$25k
...accuracy, compliance, and performance in risk adjustment and value-based care initiatives. You... ...Helpdesk Support Participate in a daily coder helpdesk (virtual/Zoom-based),... ...programs (Excel, Word, PowerPoint) Must be certified at least one of the following: CCS, CRC...RiskBi-weekly payFull timeTemporary workImmediate startRemote workWork from homeHome officeMonday to Friday- ...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,...RiskFull timePart timeSeasonal work
- ...Greatest Workplaces National Top Companies Certified as a Great Place to Work® Fortune Best... ...Services & Insurance General Liability Adjuster Primary Purpose The Commercial General Liability... ..., litigation management, and risk transfer, particularly across multi-jurisdictional...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
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$56.2k - $101k
...of practice coding patterns, education and training regarding risk adjustment to ensure accurate CMS payment and improve quality of care. Analysis... ...physician setting or a Managed Care Organization as a medical coder 2+ years of experience in coding with knowledge of Medicare...RiskFull timePart timeWork at officeRemote workFlexible hours- ...Description Summary The VP, Head of Credit Risk Portfolio Management is a senior member... ...health and risk exposure. Assess risk‑adjusted performance across business units and... ...Experience - 10 to 15 years Certifications Certified Anti‑Money Laundering Specialist (ACAMS)...RiskWork experience placement
$85k - $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... .... Multi-Line General Liability Claims Adjuster The Multi-Line General Liability Claims Adjuster...RiskWork at officeRemote workMonday to Friday- ...compassion, respect, and kindness.”Job SummaryThe Certified Medical Assistant will utilize their... ...(gloves, masks, gowns) to minimize the risk of healthcare-associated infections (HAIs... ...vision, depth perception and ability to adjust focus. The employee should have the...RiskFull timeWork at officeRotating shiftAfternoon shift
- ...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
- Centene Corporation is seeking a Senior Risk Adjustment Auditor to support CMS payments and quality of care across our provider network in New York. The role emphasizes education, audits, and data analysis of MRA patterns, with collaboration across Provider Relations and...RiskRemote job
- CRC Group is seeking a Litigation Claims Adjuster - Complex to manage high-severity claims remotely across eligible states in the United... ...coverage, coordinate with brokers and legal counsel, and contribute to risk mitigation and regulatory compliance, with a focus on quality...RiskRemote job
- ...ACME accredited midwifery program. Licensure & Certification: Certified Nurse‑Midwife (CNM) by the AMCB, renewed every 5 years; active... ...care, offering a 350‑bed facility with a 142‑bed NICU and high‑risk obstetric program. #J-18808-Ljbffr Florida Medical Clinic Orlando...RiskFull timeShift workNight shift
$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...RiskRemote jobFull timePart timeSeasonal work- ...Equal Opportunity Employer ONLY STATE OF FLORIDA CERTIFIED OFFICERS CAN APPLY A Police Officer performs responsible law enforcement functions... ...year. ESSENTIAL JOB FUNCTIONS Responds to emergency or high-risk situations; participates in criminal and other investigations....RiskLocal areaImmediate start
$107.7k - $199.3k
...engagement with Enterprise Privacy, Security and Risk Management (EPSRM) visibility and... .... Licenses/Certifications CISSP / CISM Certified Information Systems Security Professional... ...office work schedules. Actual pay will be adjusted based on an individual's skills,...RiskFull timeContract workPart timeWork at officeRemote workFlexible hours$49.72k - $92.47k
...patient severity of illness and risk factors. Collaborates with... ...Regulatory background and risk adjustment/HCC knowledge (Preferred) [... ...Licenses And Certifications Certified Clinical Documentation Specialist... ...] Certified Professional Coder (CPC) [Required] Certified Risk...RiskFull timeWork experience placementLocal areaShift work- ...The City is accepting applications for F/T Non-Certified Police Trainee for openings and to establish an eligibility list for future openings... ...'s geography Knowledge of safety procedures associated with risks and hazards inherent to the job SPECIAL REQUIREMENTS Successful...RiskTraineeshipWork at officeRotating shift
- ...impact 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
$40 per hour
...discounts to keep your credentials sharp. Peace of Mind: Full risk mitigation and professional liability coverage are provided. Supported... ..., and expectations are already handled. Minimum Qualifications Certified: Board of Certification (BOC) certified Athletic Trainer in...RiskHourly payDaily paidExtra incomeFull timeTemporary workPart timeFor contractorsLocal areaMonday to FridayFlexible hoursShift workAfternoon shift$70k
...maintenance, financial, administration & risk management. As an on-site leader, you... ...identify trends and recommend strategies and adjustments Develop yearly operating budgets/... ...combination of education and experience. Certified Apartment Manager (CAM) or Accredited Resident...RiskPermanent employmentFull timeFor contractorsWork at office- ...Responsibilities Develop continuous performance improvement and risk management programs. Ensure compliance with licensure,... ...for Total Hip Replacement in 2025 Safe Sleep Hospital - Gold Certified American College of Radiology - Mammographic Imaging Services...RiskTemporary workRelocation packageShift workWeekend workAfternoon shiftWeekday work
- The City is accepting applications for F/T Non-Certified Police Trainee for openings and to establish an eligibility list for future openings... ...'s geography Knowledge of safety procedures associated with risks and hazards inherent to the job SPECIAL REQUIREMENTS...RiskTraineeshipWork at officeRotating shift
$214.7k - $306.71k
...currently one of the most successful full-risk Medicare Advantage providers in the... ...effectiveness for each patient in their risk adjusted panel of at least 400 patients. They understand... ...Eligibility is required Once Board certified will maintain board certification in their...RiskTemporary workWork at office
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