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Certified Risk Adjustment Coder Jobs in Miami, FL

Centrum Health

Risk Adjustment Data Analyst

Doral, FL · On-site

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 Data 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 ...

Cano Health

Auditor, ACO Coding

Miami, FL · On-site

$26 - $29.75/hr

Required Certified Coder; CPC, CRC, CCS-P, CCS-H, RHIT * 3+ years of Medicare Risk Adjustment experience * Experience working in health care and insurance Industry. Education Requirements Required ...

Cano Health

Auditor, ACO Coding

Miami, FL · On-site

$26 - $29.75/hr

Required Certified Coder; CPC, CRC, CCS-P, CCS-H, RHIT * 3+ years of Medicare Risk Adjustment experience * Experience working in health care and insurance Industry. Education Requirements Required ...

Cano Health

Auditor, ACO Coding

Miami, FL · On-site

$70 - $90/hr

Required Certified Coder; CPC, CRC, CCS-P, CCS-H, RHIT3+ years of Medicare Risk Adjustment experienceExperience working in health care and insurance Industry.Education RequirementsRequired ...

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

Certified Risk Adjustment Coder information

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$28

$67

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

As of Sep 6, 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 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 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 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.

How do you become a certified risk adjustment coder?

To become a certified risk adjustment coder, you typically need to complete relevant training or coursework in medical coding and risk adjustment, gain experience in medical billing or coding, and pass a certification exam such as the Certified Risk Adjustment Coder (CRC) offered by the American Academy of Professional Coders (AAPC). Continuing education is often required to maintain certification and stay current with industry updates.

Is certified risk adjustment coding a good career?

Certified risk adjustment coding is a growing field within healthcare, focusing on accurately coding patient diagnoses for insurance reimbursement and risk assessment. It requires knowledge of medical terminology, coding systems like ICD-10, and often involves certification such as the RAC or CRC. The role offers stable employment opportunities, competitive salaries, and the potential for remote work, making it a viable career choice for those interested in healthcare administration and coding.

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 August 2026, with employment types broken down into 2% As Needed, 80% Full Time, 12% Part Time, and 6% Contract. Highlights an 96% Physical, 1% Hybrid, and 3% Remote job distribution, with an average salary of $58,266 per year, or $28 per hour.

Coding Quality Assurance (QA) Manager, Remote

Aledade PBC

Fort Lauderdale, FL • On-site, Remote

Full-time

Medical, Dental, Vision, Retirement, PTO

Posted 4 days ago

Job description

As a Coding Quality Assurance (QA) Manager, you will lead a high-performing team of QA Specialists at the intersection of clinical precision and operational excellence. You'll drive coding accuracy, build robust Standard Operating Procedures (SOPs), and ensure full audit readiness by evaluating documentation from both our internal CDI team and external partners. If you bring deep expertise in Risk Adjustment and Hierarchical Condition Categories (HCC) alongside a passion for mentoring talent and elevating compliance standards, this role offers a direct platform to shape our quality operations and make a measurable impact.
 
Candidates should be comfortable working remotely from anywhere within the US, across all US time zones.
Primary Duties
  • Team Leadership & Oversight: Lead, mentor, and manage a team of  QA Specialists. Establish team goals, monitor productivity, conduct regular performance reviews, and foster a culture of continuous learning.
  • Quality Audits: Oversee and perform comprehensive quality assurance reviews for coding completed by internal CDI staff and external vendor partners, ensuring compliance with official ICD-10-CM guidelines and risk adjustment models.
  • SOP & Guideline Development: Design, implement, and maintain standard operating procedures, audit workflows, scoring methodologies, and coding quality guidelines across the organization.
  • Payer Audit Support: Act as a key subject matter expert (SME) during external payer audits (e.g., RADV, Medicare, Commercial). Assist with chart selection, review, dispute documentation, and appeal responses.
  • Vendor Management: Evaluate third-party coding vendor accuracy rates against established SLAs. Deliver constructive feedback, identify trend errors, and drive corrective action plans when necessary.
  • Education & Feedback Loops: Translate QA audit findings into actionable insights. Provide structured feedback and target educational resources to internal CDI specialists and vendors to prevent recurring errors.
  • Other duties as assigned
Minimum Qualifications:
  • Bachelor's Degree in health care management, nursing or related field or an Associate Degree with relevant experience in CDI, coding, coding management, or HCC Risk Adjustment required.
  • Minimum of 4 years of HCC coding experience with 2 years specifically focused on coding quality assurance, auditing, or compliance monitoring.
  • Active professional credentials from AAPC and/or AHIMA required (such as CRC, CCS, CPC, or CPMA).
  • Deep mastery of ICD-10-CM coding, CMS Risk Adjustment guidelines, RADV audit rules, and clinical documentation requirements.
Preferred KSA's:
  • CRC (Certified Risk Adjustment Coder)
  • Experience working within Value-Based Care (VBC) models, ACOs, or Advantage plans.
  • Prior experience managing small teams or leading vendor oversight programs.
  • Exceptional leadership, communication, and organizational skills.
  • Proficiency with EHR systems and encoder software
Who We Are:
Aledade PBC, a public benefit corporation, exists to empower the most transformational part of our health care landscape - independent primary care. We were founded in 2014, and since then, we've become the largest network of independent primary care in the country - helping practices, health centers and clinics deliver better care to their patients and thrive in value-based care. Additionally, by creating value-based contracts across a wide variety of health plans, we aim to flip the script on the traditional fee-for-service model. Our work strengthens continuity of care, aligns incentives and ensures primary care physicians are paid for what they do best - keeping patients healthy. If you want to help create a health care system that is good for patients, good for practices and good for society - and if you're eager to join a collaborative, inclusive and remote-first culture - you've come to the right place.
 
What Does This Mean for You?
At Aledade PBC, you will be part of a creative culture that is driven by a passion for tackling complex issues with respect, open-mindedness and a desire to learn. You will collaborate with team members who bring a wide range of experiences, interests, backgrounds, beliefs and achievements to their work - and who are all united by a shared passion for public health and a commitment to the Aledade mission.
 
In addition to time off to support work-life balance and enjoyment, we offer the following comprehensive benefits package designed for the overall well-being of our team members:
 
Flexible work schedules and the ability to work remotely are available for many roles
Health, dental and vision insurance paid up to 80% for employees, dependents and domestic partners
Robust time-off plan (21 days of PTO in your first year)
Two paid volunteer days and 11 paid holidays
12 weeks paid parental leave for all new parents
Six weeks paid sabbatical after six years of service
Educational Assistant Program and Clinical Employee Reimbursement Program
401(k) with up to 4% match
Stock options
And much more!
 
At Aledade PBC, we don't just accept differences, we celebrate them! We strive to attract, develop and retain highly qualified individuals representing the diverse communities where we live and work. Aledade is committed to creating a diverse environment and is proud to be an equal opportunity employer. Employment policies and decisions at Aledade are based on merit, qualifications, performance and business needs. All qualified candidates will receive consideration for employment without regard to age, race, color, national origin, gender (including pregnancy, childbirth or medical conditions related to pregnancy or childbirth), gender identity or expression, religion, physical or mental disability, medical condition, legally protected genetic information, marital status, veteran status, or sexual orientation.
 
 
We may use automated tools, including artificial intelligence (AI), to help organize and evaluate application materials. These tools support our recruiters and hiring managers by helping manage large applicant pools. Human judgment plays an essential role in our hiring process, including in the oversight and use of any automated tools. If you would like more information about our screening and hiring process, please contact us. Our Commitment to Authenticity. We use Endorsed, a fraud detection tool, to validate the authenticity of applications and protect against identity fraud. This ensures we are connecting with real people and allows us to prioritize genuine candidates. When you apply to a job on this site, the personal data contained in your application will be collected by Aledade PBC using Lever, a cloud services provider located in the United States. Lever is engaged by Aledade PBC to help manage its recruitment and hiring processes. For more information about how your personal data will be processed by Aledade PBC and any rights you may have, please review Aledade PBC's Candidate Privacy Notice. By applying for this job, you agree to Aledade's Applicant Privacy Policy available at https://www.aledade.com/privacy-policy-applicants If you have any questions about our privacy practices, please contact [email protected].
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