Review and audit documentation for appropriate capture of CAT II coding Medicare Annual Wellness ... High School Experience: 2-5 years of risk adjustment coding E/M procedures and diagnosis experience ...
Review and audit documentation for appropriate capture of CAT II coding Medicare Annual Wellness ... High School Experience: 2-5 years of risk adjustment coding E/M procedures and diagnosis experience ...
Review and audit documentation for appropriate capture of CAT II coding Medicare Annual Wellness ... High School Experience: 2-5 years of risk adjustment coding E/M procedures and diagnosis experience ...
Review and audit documentation for appropriate capture of CAT II coding Medicare Annual Wellness ... High School Experience: 2-5 years of risk adjustment coding E/M procedures and diagnosis experience ...
Review and audit documentation for appropriate capture of CAT II coding Medicare Annual Wellness ... High School or Equivalent Experience: 2-5 years of risk adjustment coding E/M procedures and ...
Review and audit documentation for appropriate capture of CAT II coding Medicare Annual Wellness ... High School or Equivalent Experience: 2-5 years of risk adjustment coding E/M procedures and ...
Review and audit documentation for appropriate capture of CAT II coding Medicare Annual Wellness ... High School or Equivalent Experience: 2-5 years of risk adjustment coding E/M procedures and ...
Review and audit documentation for appropriate capture of CAT II coding Medicare Annual Wellness ... High School or Equivalent Experience: 2-5 years of risk adjustment coding E/M procedures and ...
Medical Risk Adjustment Coder- VBC
Winter Park, FL · On-site
$17.50 - $23.50/hr
... for Medicare/Medicare Advantage and ACO health plan members. • Reviews medical records and ... chart reviews and facilitates the accurate and timely reporting of quality measures. . • ...
Medical Risk Adjustment Coder- VBC
Winter Park, FL · On-site
$17.50 - $23.50/hr
... for Medicare/Medicare Advantage and ACO health plan members. • Reviews medical records and ... chart reviews and facilitates the accurate and timely reporting of quality measures. . • ...
Medical Risk Adjustment Coder- VBC
Winter Park, FL · On-site
$17.75 - $23.50/hr
... for Medicare/Medicare Advantage and ACO health plan members. • Reviews medical records and ... chart reviews and facilitates the accurate and timely reporting of quality measures. . • ...
Medical Risk Adjustment Coder- VBC
Winter Park, FL · On-site
$17.75 - $23.50/hr
... for Medicare/Medicare Advantage and ACO health plan members. • Reviews medical records and ... chart reviews and facilitates the accurate and timely reporting of quality measures. . • ...
Medical Risk Adjustment Coder- VBC
$17.50 - $23.50/hr
... for Medicare/Medicare Advantage and ACO health plan members. • Reviews medical records and ... chart reviews and facilitates the accurate and timely reporting of quality measures. . • ...
Medical Risk Adjustment Coder- VBC
$17.50 - $23.50/hr
... for Medicare/Medicare Advantage and ACO health plan members. • Reviews medical records and ... chart reviews and facilitates the accurate and timely reporting of quality measures. . • ...
HCC Risk Coder (CDIS) - Remote in FL
Leesburg, FL · On-site +1
$16.75 - $22.25/hr
... chart reviews while providing education and facilitating chart retrieval for Health Plan audits and ... training in Medicare Risk Adjustment (MRA), HCC coding documentation guidelines, rules, and ...
New
HCC Risk Coder (CDIS) - Remote in FL
Leesburg, FL · On-site +1
$16.75 - $22.25/hr
... chart reviews while providing education and facilitating chart retrieval for Health Plan audits and ... training in Medicare Risk Adjustment (MRA), HCC coding documentation guidelines, rules, and ...
New
Risk Adjustment Coordinator, Remote, Baptist Health Integrated Care, FT, 08A-4:30P
Boca Raton, FL · Remote
$25.37 - $32.22/hr
... Medicare beneficiaries, and others to represent the department and the health system while working ... This position is responsible for chart review and up-coding workflows. The position will also ...
New
Risk Adjustment Coordinator, Remote, Baptist Health Integrated Care, FT, 08A-4:30P
Boca Raton, FL · Remote
$25.37 - $32.22/hr
... Medicare beneficiaries, and others to represent the department and the health system while working ... This position is responsible for chart review and up-coding workflows. The position will also ...
New
Review and audit documentation for appropriate capture of CAT II coding, Medicare Annual Wellness ... Education: High School or Equivalent Experience: 2-5 years of risk adjustment coding, E/M ...
Review and audit documentation for appropriate capture of CAT II coding, Medicare Annual Wellness ... Education: High School or Equivalent Experience: 2-5 years of risk adjustment coding, E/M ...
Review and audit documentation for appropriate capture of CAT II coding, Medicare Annual Wellness ... High School Experience: 2-5 years of risk adjustment coding, E/M, procedures and diagnosis ...
Review and audit documentation for appropriate capture of CAT II coding, Medicare Annual Wellness ... High School Experience: 2-5 years of risk adjustment coding, E/M, procedures and diagnosis ...
Risk Adjustment Analyst
Doral, FL · On-site
ACA, Medicare, ACO REACH, MSSP, and Medicaid. The Risk Adjustment and Quality Analyst will be responsible for working both independently and collaboratively between multiple departments such as ...
Risk Adjustment Analyst
Doral, FL · On-site
ACA, Medicare, ACO REACH, MSSP, and Medicaid. The Risk Adjustment and Quality Analyst will be responsible for working both independently and collaboratively between multiple departments such as ...
Risk Adjustment Coordinator, Remote, Baptist Health Integrated Care, FT, 08A-4:30P
Boca Raton, FL · On-site +1
$25.37 - $32.22/hr
This position is responsible for chart review and up-coding workflows. The position will also ... Medicare beneficiaries, and others to represent the department and the health system while working ...
Risk Adjustment Coordinator, Remote, Baptist Health Integrated Care, FT, 08A-4:30P
Boca Raton, FL · On-site +1
$25.37 - $32.22/hr
This position is responsible for chart review and up-coding workflows. The position will also ... Medicare beneficiaries, and others to represent the department and the health system while working ...
Risk Adjustment Analyst
Doral, FL · On-site
ACA, Medicare, ACO REACH, MSSP, and Medicaid. The Risk Adjustment and Quality Analyst will be responsible for working both independently and collaboratively between multiple departments such as ...
Risk Adjustment Analyst
Doral, FL · On-site
ACA, Medicare, ACO REACH, MSSP, and Medicaid. The Risk Adjustment and Quality Analyst will be responsible for working both independently and collaboratively between multiple departments such as ...
Certified Risk Adjustment Coder
Hialeah, FL · On-site
$20.50 - $27.75/hr
Demonstrates knowledge of coding and documentation standards as well as CMS risk adjustment ... Completes patient medical chart review within 24-48 hours of visit completion * Responsible for ...
Certified Risk Adjustment Coder
Hialeah, FL · On-site
$20.50 - $27.75/hr
Demonstrates knowledge of coding and documentation standards as well as CMS risk adjustment ... Completes patient medical chart review within 24-48 hours of visit completion * Responsible for ...
Certified Risk Adjustment Coder
$20.50 - $27.75/hr
Demonstrates knowledge of coding and documentation standards as well as CMS risk adjustment ... Completes patient medical chart review within 24-48 hours of visit completion * Responsible for ...
Certified Risk Adjustment Coder
$20.50 - $27.75/hr
Demonstrates knowledge of coding and documentation standards as well as CMS risk adjustment ... Completes patient medical chart review within 24-48 hours of visit completion * Responsible for ...
Auditor, Risk Adjustment
Miami, FL · Remote
$82K - $108K/yr
... Medicare & Medicaid Services (CMS), Health and Human Services (HHS) audits and medical record ... Review the performance of the Risk Adjustment Coding team and report audit trends to Leadership in ...
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Auditor, Risk Adjustment
Miami, FL · Remote
$82K - $108K/yr
... Medicare & Medicaid Services (CMS), Health and Human Services (HHS) audits and medical record ... Review the performance of the Risk Adjustment Coding team and report audit trends to Leadership in ...
Certified Risk Adjustment Coder
Hialeah, FL · On-site
$20.50 - $27.75/hr
Demonstrates knowledge of coding and documentation standards as well as CMS risk adjustment ... Completes patient medical chart review within 24-48 hours of visit completion * Responsible for ...
Certified Risk Adjustment Coder
Hialeah, FL · On-site
$20.50 - $27.75/hr
Demonstrates knowledge of coding and documentation standards as well as CMS risk adjustment ... Completes patient medical chart review within 24-48 hours of visit completion * Responsible for ...
Medicare Risk Adjustment Billing Specialist - Hybrid
Jacksonville, FL · Hybrid
$22 - $25/hr
The person handling this position is responsible for ensuring all risk ICD-10 codes are properly ... Review clinical documentation and make sure accurate diagnosis codes and procedure codes are ...
Medicare Risk Adjustment Billing Specialist - Hybrid
Jacksonville, FL · Hybrid
$22 - $25/hr
The person handling this position is responsible for ensuring all risk ICD-10 codes are properly ... Review clinical documentation and make sure accurate diagnosis codes and procedure codes are ...
Medicare Risk Adjustment Chart Review information
What are some common challenges faced in a Medicare Risk Adjustment Chart Review role, and how can they be managed?
A common challenge in Medicare Risk Adjustment Chart Review is ensuring the accuracy and completeness of medical documentation to support proper coding and risk adjustment. Reviewers often encounter incomplete records or ambiguous provider notes, which requires strong attention to detail and effective communication with healthcare staff to clarify information. Staying current with CMS guidelines and coding updates is essential, as regulations and requirements can change frequently. Proactively collaborating with providers and participating in regular training sessions can help manage these challenges and improve review quality.
What is Medicare Risk Adjustment Chart Review?
Medicare Risk Adjustment Chart Review is a process where healthcare professionals review patient medical records to identify and validate diagnoses that impact Medicare Advantage risk scores. This ensures that Medicare Advantage plans receive accurate reimbursement based on the health status and complexity of their enrollees. The review helps to capture any conditions that may not have been coded during patient visits, improving data accuracy and compliance with CMS regulations.
What is the difference between Medicare Risk Adjustment Chart Review vs Medical Coder?
| Aspect | Medicare Risk Adjustment Chart Review | Medical Coder |
|---|---|---|
| Primary Focus | Reviewing patient charts to ensure accurate risk adjustment data for Medicare | Assigning medical codes based on clinical documentation for billing and records |
| Certifications | Often requires coding certifications and knowledge of Medicare guidelines | Certified Professional Coder (CPC) or equivalent |
| Work Environment | Healthcare facilities, insurance companies, or remote | Hospitals, clinics, or billing companies |
| Industry Usage | Medicare Advantage plans, risk adjustment programs | Medical billing, coding, and documentation |
While both roles involve medical documentation, Medicare Risk Adjustment Chart Review focuses on analyzing charts to optimize Medicare risk scores, whereas Medical Coders assign codes for billing purposes. Understanding these differences helps in choosing the right career path or job focus within healthcare documentation and billing.
What are the key skills and qualifications needed to thrive as a Medicare Risk Adjustment Chart Reviewer, and why are they important?
To thrive as a Medicare Risk Adjustment Chart Reviewer, you need a solid understanding of medical coding (CPT, ICD-10), healthcare compliance, and clinical documentation, often supported by a coding certification such as CPC, CRC, or CCS. Familiarity with electronic medical records (EMRs), risk adjustment software, and auditing tools is typically required. Attention to detail, analytical thinking, and strong communication skills set top performers apart in accurately interpreting and reporting clinical data. These competencies are crucial for ensuring accurate risk adjustment, regulatory compliance, and optimized reimbursement for healthcare organizations.
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What job categories do people searching Medicare Risk Adjustment Chart Review jobs in Florida look for? The top searched job categories for Medicare Risk Adjustment Chart Review jobs in Florida are:
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Job description
MRA Coder
The MRA Coder will be responsible for coordinating/supporting retrospective and concurrent chart reviews using knowledge of Hierarchical Condition Categories (HCC) coding to translate, input, extract and validate medical record data.
- Review patient medical history and physical exams, physician orders, progress notes, consultation reports, diagnostic reports, operative and pathology reports, and discharge summaries in order to verify whether the diagnosis codes are supported by the documentation to ensure they are within Guidelines for Coding and Reporting
- Schedule chart reviews with Physician practices
- Assist in obtaining medical records from Physicians to support audits requested by Health Plans
- Ensure compliance with all applicable Federal, State and/or County laws and regulations related to coding and documentation guidelines for Risk Adjustment.
- Educate Physicians regarding proper billing and documentation policies, procedures, and conflicting/ambiguous or non-specific documentation
- Demonstrate the ability to quickly identify low risk scores; incorrect coding and compliance trends; to analyze and investigate suspected problems with resolve; and to forward problems to the attention of the Medicare Risk Adjustment Director
- Performs other duties as required.
Requirements:
- CPC /CPMA/ CRC/ CCS-P/ CCS/ RHIA or RHIT certification
- Minimum 3 years of Medicare Risk Adjustment coding
- Advanced Microsoft Excel
- Familiar with HCC Dashboard tool
- Strong knowledge of ICD-10 and CPT codes
- Fluent in English and Spanish
- Clean driving record and reliable form of transportation
About Genuine Health Group
Sourced by ZipRecruiter
Industry
Health care and social assistance
Company size
11 - 50 Employees
Headquarters location
Miami, FL, US
Year founded
2017