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  • Description PRIMARY PURPOSE: The Risk Adjustment Coder plays a critical role in ensuring accurate documentation and coding of chronic conditions to support value-based care initiatives and optimize risk scores for reimbursement. This position focuses on Hierarchical Condition... 
    Risk

    Foundcare, Inc.

    West Palm Beach, FL
    4 days ago
  • Job Overview We’re ChenMed - a family‑owned, physician‑led practice transforming healthcare for seniors. Join us as a Risk Adjustment Coder and help improve the quality of care while supporting our patients and team. The role involves reviewing medical records, identifying... 
    Risk
    Work at office
    Remote work

    ChenMed

    Miami, FL
    4 days ago
  • $193k - $242k

     ...healthcare. Role Overview As the Director of Prospective + Concurrent Risk Adjustment Products, you will lead the strategy, roadmap, and execution...  .... Background in working with provider documentation teams, coders, or concurrent review vendors. Clinical experience or deep... 
    Risk

    Datavant

    Tallahassee, FL
    5 days ago
  • Overview Medical Director Opportunity - Medicare Risk Adjustment HCC Review - Puerto Rico (Option to be Florida Based)!! Option to either live...  ...record reviews in tandem with a certified professional coder at provider locations or at company9s offices Facilitate query... 
    Risk
    Full time
    Live in
    Work at office

    Doctor’s Choice Placement Services

    Orlando, FL
    23 hours ago
  •  ...seeking a detail-oriented and proactive  Claims Examiner to join our risk management team. In this role, you will be responsible for...  ...carriers Required Qualifications: Florida 6-20 All-Lines Adjuster License (or ability to obtain within 90 days of hire) At least... 
    Risk
    Permanent employment
    Contract work
    Temporary work
    Work at office

    Questpro

    Hollywood, FL
    24 days ago
  • $77.97k - $141.37k

    JOB DESCRIPTION Job Summary Responsible for being the SME (Subject Matter Expert) for Medicaid risk adjustment programs in multiple states. Maintain risk adjustment model, estimate risk scores, and analyze impact. Extract, analyze, and synthesize data from various sources... 
    Risk
    Remote job
    Work experience placement

    Molina Healthcare

    Miami, FL
    5 days ago
  • $77.97k - $140k

    JOB DESCRIPTION Job Summary Responsible for Medicare risk adjustment related estimates, establishing premium rates, financial analysis, and reporting. Extracts, analyzes, and synthesizes data from various sources to identify risks. Maintain/update SQL model(s), estimate... 
    Risk
    Remote job
    Work experience placement

    Molina Healthcare

    Miami, FL
    5 days ago
  • $77.97k - $140k

    Job Summary Responsible for Medicare risk adjustment related estimates, establishing premium rates, financial analysis, and reporting. Extracts, analyzes, and synthesizes data from various sources to identify risks. Maintain/update SQL model(s), estimate risk scores, and... 
    Risk
    Remote job
    Work experience placement

    Molina Healthcare

    Tampa, FL
    1 day ago
  • InnovaCare Management Services Company, LLC is seeking a Manager, Risk Adjustment Operations to strengthen and improve practice operations, resulting in stronger patient acuity capture and improved population health management. The successful candidate will provide operational... 
    Risk
    Work at office

    InnovaCare Health

    Orlando, FL
    1 day ago
  • Manager, Risk Adjustment Operations As a Manager, Risk Adjustment Operations you'll provide operational services to strengthen and improve practice operations that result in stronger patient acuity capture and improved population health management. You'll use your subject... 
    Risk
    Work at office
    Remote work
    Flexible hours

    InnovaCare Health

    Jacksonville, FL
    2 days ago
  • $50.2k

     ...recommends process improvements for efficiencies. May provide guidance to Associate level employees. This role sits within our Risk Adjustment team - it is a remote based role - looking for someone who has some claims experience and looking to become familiar with risk... 
    Risk
    For contractors
    Work at office
    Local area
    Remote work

    Highmark Health

    Tallahassee, FL
    1 day ago
  • Risk Adjustment Coding Specialist REMOTE Formed in 2008 and headquartered in Fort Myers, Florida, with offices in Florida, North Carolina, and Texas, Millennium Physician Group (MPG) is the largest independent physician group in the state of Florida and one of the largest... 
    Risk
    Remote work

    Millennium Physician Group

    Fort Myers, FL
    3 days ago
  • $141.44k - $212.16k

     ...lead a key execution component of a critical program focused on Adjustment Reduction and Data Automation, directly tied to key regulatory...  ...third lines of defense. Effectively communicate program status, risks, and issues. Regulatory Interaction: Serve as the primary point... 
    Risk
    Full time

    Citigroup Inc.

    Tampa, FL
    3 days ago
  • $77.97k - $155.51k

     ...DESCRIPTION Job Summary This Sr. Analyst, Healthcare Analytics role will be responsible for work around Program Valuation on Molina's Risk Adjustment Actuarial team. Responsibilities include research, analysis and modeling of complex healthcare claims data, pharmacy data, lab... 
    Risk
    Remote job
    Work experience placement

    Molina Healthcare

    Orlando, FL
    5 days ago
  •  ...Competencies: ACCOUNTABILITY, ACCURACY (DRG), ACCURACY - CODER, ACCURACY - OUTPATIENT, ANALYSIS AND DECISION MAKING, CUSTOMER...  ...CPC), Certified Professional Medical Auditor (CPMA), Certified Risk Adjustment Coder (CRC) by AAPC, or Certified Coding Specialist (CCS),... 
    Risk
    Work experience placement
    Work at office
    Local area
    Shift work

    Memorial Healthcare System

    Hollywood, FL
    4 days ago
  • JOB SUMMARY The Risk Adjustment Analyst Sr is responsible for monitoring and oversight of the end-to-end encounter management workflow. This position analyzes complex encounter inbound/outbound process issues, using data from internal and external sources to provide insight... 
    Risk
    Work experience placement
    Immediate start

    Baylor Scott & White Health

    Tallahassee, FL
    1 day ago
  • $145k - $170k

     ...professional, educational and life experiences to realize our bold vision for healthcare. Role Overview As a Product Manager, Risk Adjustment Coding Data Integration, you will own the data strategy and execution for Datavant’s Retrospective Risk Adjustment Coding products... 
    Risk

    Datavant

    Tallahassee, FL
    2 days ago
  • $68.7k - $123.7k

    Senior, Compliance Risk Adjustment Analyst Join to apply for the Senior, Compliance Risk Adjustment Analyst role at Centene Corporation Senior, Compliance Risk Adjustment Analyst Join to apply for the Senior, Compliance Risk Adjustment Analyst role at Centene Corporation... 
    Risk
    16 hours
    Full time
    Part time
    Work at office
    Remote work
    Work from home
    Flexible hours

    Centene Corporation

    Orlando, FL
    4 days ago
  • $117.2k - $222.5k

     ...ll also conduct competitive benchmarking and identify emerging risks and opportunities in a rapidly evolving healthcare landscape. This...  ...experience. Bonus Points Experience in Medicare Advantage Risk Adjustment highly preferred What You\'ll Get The opportunity to work at... 
    Risk

    Blue Cross and Blue Shield of North Carolina

    Jacksonville, FL
    3 days ago
  •  ...Coding Certification from AHIMA or AAPC ~3+ years CURRENT Inpatient Coder work experience in an acute care hospital ~ EPIC/3M experience a plus ~ This is facility coding (no risk adjustment or profee) ~ The coders should have 3 years current inpatient coding experience... 
    Risk
    Work experience placement
    Remote work

    Beacon Hill Staffing Group

    Celebration, FL
    more than 2 months ago
  • $19.89 - $27.85 per hour

     ...Required/ Preferred and/or CPC (Certified Professional Coder) Preferred or COC (Certified Outpatient Coding)...  ...Preferred or Additional Requirements CRC (Certified Risk Adjustment Coder) required -or- CIC (Certified Inpatient Coder) required... 
    Risk
    Full time
    Casual work
    Remote work
    Shift work

    Lee Health

    Cape Coral, FL
    4 days ago
  • $19.89 - $27.85 per hour

     ...certifications from AAPC or AHIMA will be considered. CPC (Certified Professional Coder) COC (Certified Outpatient Coding) CPC-P (Certified Professional Coder-Payer) CRC (Certified Risk Adjustment Coder) CIC (Certified Inpatient Coder) CCS (Certified Coding... 
    Risk
    Full time
    Casual work
    Remote work
    Shift work

    Lee Health

    Cape Coral, FL
    4 days ago
  •  ...coding experience. Physician Billing Credentials For Physician Billing: Certified Professional Coder (CPC), Certified Professional Medical Auditor (CPMA), Certified Risk Adjustment Coder (CRC) by AAPC, or Certified Coding Specialist (CCS), Certified Coding Specialist -... 
    Risk
    Full time
    Work experience placement
    Work at office
    Local area

    Memorial Healthcare System

    Miramar, FL
    3 days ago
  •  ...Role Description: The Certified Medical Coder is responsible for analyzing provider documentation...  .... Skills Required: Minimum 2 years of risk coding experience, preferably in primary...  ...(CPC) required; Certification in Risk Adjustment Coding (CRC) preferred High school... 
    Risk
    Full time
    Work at office
    Remote work
    Work from home
    Shift work

    Upward Health

    Kissimmee, FL
    4 days ago
  • Auditing Manager CPC Coders Hybrid work setting, Florida residency required As Mount Sinai grows, so does our legacy in high-quality health...  ...the institution. Analyze audit findings and identify trends, risks, and opportunities for improvement. Team Leadership &... 
    Risk
    Work at office

    International Executive Service Corps

    Miami Beach, FL
    3 days ago
  •  ...industry standard for global medical cost containment and medical risk management solutions. Learn more here . Iris, Powered by...  ...here . What you’ll be doing. Job Summary: The Liability Claims Adjuster will be reporting to the Supervisor, Liability Claims. This position... 
    Risk
    Temporary work
    Work at office
    Local area
    Work from home
    Monday to Friday
    2 days per week
    3 days per week

    GMMI Inc.

    Hollywood, FL
    2 days ago
  • Specialist III, Medical Coding Adjustment Join to apply for the Specialist III, Medical Coding...  ...Hierarchical Condition Categories (HCC)/Risk Adjustment. Advanced knowledge and understanding...  ..., preferred. Certified Procedural Coder (CPC), CRC designation preferred. Certified... 
    Risk
    Full time
    Temporary work
    Remote work
    Monday to Friday

    Millennium Physician Group

    Fort Myers, FL
    2 days ago
  • Medical Coding Adjustment Specialist II Millennium Physician Group Full Time (Monday-Friday 8...  ...Hierarchical Condition Categories (HCC)/Risk Adjustment. • Possesses advanced knowledge...  ...experience, preferred. • Certified Procedural Coder (CPC), CRC designation preferred. •... 
    Risk
    Full time
    Temporary work
    Remote work
    Monday to Friday

    Millennium Physician Group

    Fort Myers, FL
    2 days ago
  • $50k

     ...Description General Liability Claims Specialist · New York Adjusters License Needed   Work-From-Home   Comprehensive Benefits...  ...benefits package.   Company Description North American Risk Services (NARS) is a premier third-party claims administrator that... 
    Risk
    Work at office
    Work from home

    North American Risk Services, Inc. (NARS)

    Jacksonville, FL
    1 day ago
  •  ...Position Summary The ideal candidate is an experienced, all-lines adjuster, with at least one year of PIP handling experience for Florida...  ...claims professionals, to resolve complex claims and mitigate risk effectively. · Identify opportunities for process improvement... 
    Risk
    Work at office

    Policy Services Company LLC

    Coral Springs, FL
    5 days ago