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Hcc Risk Adjustment Coder Jobs in Miami, FL (NOW HIRING)

Msmc

Certified Risk Adjustment Coder

Hialeah, FL · On-site

$20.50 - $27.75/hr

Regularly reviews Epic HCC and payor CSI (Clinically Suspect Conditions) reports * Queries and ... risk adjustment coding * Demonstrates understanding of risk adjustment payment models * Uses ...

Centrum Health

Risk Adjustment Analyst

Doral, FL · On-site

Using SQL code, mine data on medical spend, clinical data and population health data and derive ... Familiarity with CMS-HCC and HHS-HCC risk Adjustment Models * Familiarity with HEDIS and MSSP ...

New

Centrum Health

Risk Adjustment Analyst

Doral, FL · On-site

Using SQL code, mine data on medical spend, clinical data and population health data and derive ... Familiarity with CMS-HCC and HHS-HCC risk Adjustment Models * Familiarity with HEDIS and MSSP ...

Oscar Health

Auditor, Risk Adjustment

Miami, FL · Remote

$82K - $108K/yr

The Associate, Risk Adjustment Auditor conducts internal and external quality audits ... Quality audits are specific to ICD-10 code abstraction relative to accuracy, completeness, and ...

PCC MEDICAL HOLDINGS LLC

Remote Medical Coder

Miami, FL · On-site

$21 - $26/hr

... risk adjustment performance. Under the supervision of the Revenue Cycle Manager, you'll review ... Ensure complete and compliant documentation and precise HCC capture. * Query providers to clarify ...

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 ...

BHP

Director Value Base - BHP

Fort Lauderdale, FL · On-site

... risk adjustment coding for the ambulatory division. This includes all specialty and primary care ... Hierarchical Condition Category (HCC) Medical Loss Ratio (MLR) Risk Certification Risk Auditor ...

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Hcc Risk Adjustment Coder information

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

As of Jul 2, 2026, the average hourly pay for hcc risk adjustment coder in Miami, FL is $26.29, according to ZipRecruiter salary data. Most workers in this role earn between $18.17 and $33.12 per hour, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive in the Hcc Risk Adjustment Coder position, and why are they important?

To thrive as an HCC Risk Adjustment Coder, you need a solid understanding of medical coding, ICD-10-CM coding guidelines, and clinical documentation, often demonstrated by a certification such as CPC, CRC, or CCS-P. Familiarity with EHR systems, risk adjustment software, and coding databases is commonly required. Attention to detail, analytical thinking, and strong communication skills set top coders apart in this field. These skills are critical for accurately capturing patient risk, ensuring compliance, and supporting optimal reimbursement for healthcare organizations.

What are some common challenges faced by HCC Risk Adjustment Coders, and how can they overcome them?

HCC Risk Adjustment Coders often encounter challenges such as incomplete or ambiguous provider documentation, frequent code updates, and tight coding accuracy standards. Staying current on industry coding guidelines, maintaining open communication with providers, and participating in regular training programs are essential strategies for overcoming these hurdles. Coders who proactively seek clarification, double-check their work, and embrace ongoing learning typically excel in this role. Addressing these challenges effectively not only improves coding quality but also supports accurate reimbursement and risk adjustment reporting.

What is an HCC Risk Adjustment Coder job?

An HCC Risk Adjustment Coder reviews medical records to identify and assign accurate Hierarchical Condition Category (HCC) codes based on documented diagnoses. These codes help determine risk adjustment scores, which impact healthcare reimbursements for Medicare Advantage and other risk-adjusted plans. Coders ensure compliance with CMS guidelines, improve documentation accuracy, and support proper reimbursement for patient care. Strong knowledge of ICD-10-CM coding, medical terminology, and risk adjustment models is essential for this role.

What are the most commonly searched types of Hcc Risk Adjustment Coder jobs in Miami, FL? The most popular types of Hcc Risk Adjustment Coder jobs in Miami, FL are:
What are popular job titles related to Hcc Risk Adjustment Coder jobs in Miami, FL? For Hcc Risk Adjustment Coder jobs in Miami, FL, the most frequently searched job titles are:
What job categories do people searching Hcc Risk Adjustment Coder jobs in Miami, FL look for? The top searched job categories for Hcc Risk Adjustment Coder jobs in Miami, FL are:
Hcc Risk Adjustment Coder jobs near you
Certified Risk Adjustment Coder

Certified Risk Adjustment Coder

Mount Sinai Medical Center

Hialeah, FL • On-site

$20.50 - $27.75/hr

Full-time

Medical, Life, Retirement, PTO

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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