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Certified Risk Adjustment Coder Jobs in Miami, FL

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$16

$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.

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For Certified Risk Adjustment Coder jobs in Miami, FL, the most frequently searched job titles are:

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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.

Nurse Practitioner

Preferred Family Care, Inc.

Miami, FL • On-site

Full-time

Re-posted yesterday

Job description

We're Hiring! Nurse Practitioner – Medicare Experience | North Miami Beach

Join a compassionate and dynamic healthcare team that values excellence, innovation, and patient-centered care. We are currently seeking an experienced Nurse Practitioner for our North Miami Beach location with a strong background in Medicare Advantage, HEDIS measures, and MRA coding.

Position: Nurse Practitioner (NP)
Location: North Miami Beach, FL
Schedule: Full-time

✨ Key Responsibilities:

  • Conduct comprehensive patient assessments, focusing on chronic condition management and preventive care
  • Accurately document HCC (Hierarchical Condition Categories) for MRA (Medicare Risk Adjustment)
  • Ensure compliance with HEDIS (Healthcare Effectiveness Data and Information Set) performance measures
  • Develop individualized care plans and educate patients on condition management
  • Collaborate with interdisciplinary teams for optimal patient outcomes
  • Utilize EHR systems efficiently to maintain accurate and timely documentation
  • Ensure regulatory and clinical compliance in all aspects of care delivery

✅ Requirements:

  • Active Florida APRN license & national board certification (FNP preferred)
  • Minimum 2 years of experience working with Medicare patients
  • Strong understanding of HEDIS measures and MRA coding
  • Experience with chronic care management and preventative screenings
  • Excellent interpersonal, clinical, and documentation skills
  • Bilingual ( English/Creole) preferred