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Certified Risk Adjustment Coder Jobs in Miami, FL

BHC ISC

PBO Risk Adjustment Coding

Fort Lauderdale, FL · On-site

Certified Professional Coder (CPC) and Certified Risk Adjustment Coder (CRC) Visit us online at www.BrowardHealth.org or contact Talent Acquisition *Bonus Exclusions may apply in accordance with ...

BHC ISC

PBO Risk Adjustment Coding

Fort Lauderdale, FL · On-site

Certified Professional Coder (CPC) and Certified Risk Adjustment Coder (CRC). Proficient in Microsoft Word Excel and PowerPoint. Competent in Electronic Health Records NextGen and Cerner experience ...

Oscar Health

Auditor, Risk Adjustment

Miami, FL · Remote

$82K - $108K/yr

Certified professional coder (CPC) * 3+ year(s) retrospective risk adjustment coding experience. * 1+ year(s) experience Quality Auditing and/or Risk Adjustment Data Validation Audit (RADV ...

CLAREMEDICA HEALTH PARTNERS LLC

Medical Coder I

Miami, FL · On-site

$18 - $24/hr

CRC - Certified Risk Adjustment Coder, preferred. * Maintain coding certification and attend in-service training as required. * Two (2) years of medical coding experience, preferably. * Understanding ...

Centrum Health

Risk Adjustment Analyst

Doral, FL

SCOPE OF ROLE The Risk Adjustment and Analytics Team is working to push boundaries to redefine Risk ... Using SQL code, mine data on medical spend, clinical data and population health data and derive ...

Centrum Health

Risk Adjustment Analyst

Doral, FL · On-site

The Risk Adjustment Analyst will be the lead in the design, implementation, and maintenance of all ... Using SQL code, mine data on medical spend, clinical data and population health data and derive ...

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All JobsCertified Risk Adjustment Coder JobsCertified Risk Adjustment Coder Jobs in Miami, FL

Certified Risk Adjustment Coder information

See Miami, FL salary details

$16

$28

$67

How much do certified risk adjustment coder jobs pay per hour?

As of Aug 2, 2026, the average hourly pay for certified risk adjustment coder in Miami, FL is $28.01, according to ZipRecruiter salary data. Most workers in this role earn between $20.91 and $27.84 per hour, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive as a Certified Risk Adjustment Coder, and why are they important?

To thrive as a Certified Risk Adjustment Coder, you need expertise in medical coding, a thorough understanding of ICD-10-CM guidelines, and certification such as CRC (Certified Risk Adjustment Coder). Familiarity with coding software, electronic health records (EHRs), and risk adjustment models like HCC is typically required. Attention to detail, analytical thinking, and strong communication skills help ensure accurate code assignment and effective collaboration with healthcare providers. These skills and qualifications are crucial for capturing precise patient data, which directly impacts healthcare reimbursement and compliance.

What is a Certified Risk Adjustment Coder?

A Certified Risk Adjustment Coder is a professional who specializes in reviewing and coding medical records to ensure accurate documentation of diagnoses for risk adjustment purposes. These coders play a crucial role in healthcare reimbursement, especially for Medicare Advantage and other risk-adjusted health plans. They analyze patient records using ICD-10-CM codes to help healthcare organizations receive appropriate compensation based on the severity of patient conditions. Certified Risk Adjustment Coders typically hold certifications such as the CRC from the AAPC, demonstrating their expertise in this specialized field.

What are some common challenges Certified Risk Adjustment Coders face, and how can they overcome them?

Certified Risk Adjustment Coders often encounter challenges such as staying current with evolving coding guidelines and accurately interpreting complex medical records. To overcome these difficulties, coders should regularly participate in ongoing education, leverage resources from professional organizations, and collaborate closely with providers to clarify documentation. Maintaining a strong attention to detail and utilizing coding software tools can also help minimize errors and improve coding accuracy. Engaging in peer reviews within the team can further enhance consistency and knowledge sharing.

What is the difference between Certified Risk Adjustment Coder vs Certified Medical Coder?

AspectCertified Risk Adjustment CoderCertified Medical Coder
CertificationsRequires risk adjustment-specific credentials like RAC, CRC, or CPC-RRequires CPC or CCS certifications
Work EnvironmentPrimarily in health insurance, risk adjustment, and payer settingsHospitals, clinics, physician offices, and outpatient facilities
Industry UsageUsed mainly in health insurance and risk adjustment programsUsed across healthcare providers for medical coding and billing

The Certified Risk Adjustment Coder specializes in coding for risk adjustment programs within health insurance, focusing on accurate documentation for reimbursement. In contrast, the Certified Medical Coder works across various healthcare settings, primarily coding diagnoses and procedures for billing. While both roles require coding certifications, their focus areas and work environments differ significantly.

What are popular job titles related to Certified Risk Adjustment Coder jobs in Miami, FL? For Certified Risk Adjustment Coder jobs in Miami, FL, the most frequently searched job titles are:
What job categories do people searching Certified Risk Adjustment Coder jobs in Miami, FL look for? The top searched job categories for Certified Risk Adjustment Coder jobs in Miami, FL are:
Certified Risk Adjustment Coder jobs near you
Infographic showing various Certified Risk Adjustment Coder job openings in Miami, FL as of July 2026, with employment types broken down into 1% As Needed, 78% Full Time, 14% Part Time, and 7% Contract. Highlights an 91% Physical, 2% Hybrid, and 7% Remote job distribution, with an average salary of $58,266 per year, or $28 per hour.

Certified Risk Adjustment Coder

Msmc

Hialeah, FL

$20.50 - $27.75/hr

Full-time

Medical, Life, Retirement, PTO

Re-posted 20 days ago

Job description

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:

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