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 ...
Risk Adjustment Coordinator, Hybrid, Palm Beach, Baptist Health Integrated Care, FT, 08A-4:30P
Boca Raton, FL · Hybrid
$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 ...
Risk Adjustment Coordinator, Hybrid, Palm Beach, Baptist Health Integrated Care, FT, 08A-4:30P
Boca Raton, FL · Hybrid
$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 ...
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. . • ...
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 ...
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. . • ...
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 Coordinator, Hybrid, Palm Beach, Baptist Health Integrated Care, FT, 08A-4:30P
Boca Raton, FL · On-site
$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, Hybrid, Palm Beach, Baptist Health Integrated Care, FT, 08A-4:30P
Boca Raton, FL · On-site
$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 ...
Auditor, ACO Coding
Miami, FL · On-site
$26 - $29.75/hr
... Adjustment. You implement ongoing quality improvement activities to assure the Medicare Risk score meets all requirements and act as a consulting MRA advisor to the practices you support. You review ...
New
Auditor, ACO Coding
Miami, FL · On-site
$26 - $29.75/hr
... Adjustment. You implement ongoing quality improvement activities to assure the Medicare Risk score meets all requirements and act as a consulting MRA advisor to the practices you support. You review ...
New
Auditor, ACO Coding
Miami, FL · On-site
$26 - $29.75/hr
... Adjustment. You implement ongoing quality improvement activities to assure the Medicare Risk score meets all requirements and act as a consulting MRA advisor to the practices you support. You review ...
New
Auditor, ACO Coding
Miami, FL · On-site
$26 - $29.75/hr
... Adjustment. You implement ongoing quality improvement activities to assure the Medicare Risk score meets all requirements and act as a consulting MRA advisor to the practices you support. You review ...
New
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 ...
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 ...
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 ...
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 ...
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 ...
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 ...
ACN Physician
Debary, FL · On-site
$180K - $210K/yr
Extensive Knowledge of Medicare Advantage Plans, HEDIS Measures, Medicare Risk Adjustment (MRA ... Review Laboratory and Diagnostic Results and Provide Appropriate Follow-Up Care * Participate in ...
ACN Physician
Debary, FL · On-site
$180K - $210K/yr
Extensive Knowledge of Medicare Advantage Plans, HEDIS Measures, Medicare Risk Adjustment (MRA ... Review Laboratory and Diagnostic Results and Provide Appropriate Follow-Up Care * Participate in ...
Risk Adjustment Data 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 Data 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 ...
ACN Physician
Debary, FL · On-site
$210K/yr
Extensive Knowledge of Medicare Advantage Plans, HEDIS Measures, Medicare Risk Adjustment (MRA ... Review Laboratory and Diagnostic Results and Provide Appropriate Follow-Up Care * Participate in ...
ACN Physician
Debary, FL · On-site
$210K/yr
Extensive Knowledge of Medicare Advantage Plans, HEDIS Measures, Medicare Risk Adjustment (MRA ... Review Laboratory and Diagnostic Results and Provide Appropriate Follow-Up Care * Participate in ...
ACN Physician
Debary, FL · On-site
$180K - $210K/yr
Extensive Knowledge of Medicare Advantage Plans, HEDIS Measures, Medicare Risk Adjustment (MRA ... Review Laboratory and Diagnostic Results and Provide Appropriate Follow-Up Care * Participate in ...
ACN Physician
Debary, FL · On-site
$180K - $210K/yr
Extensive Knowledge of Medicare Advantage Plans, HEDIS Measures, Medicare Risk Adjustment (MRA ... Review Laboratory and Diagnostic Results and Provide Appropriate Follow-Up Care * Participate in ...
ACN Physician
Debary, FL · On-site
$180K - $210K/yr
Extensive Knowledge of Medicare Advantage Plans, HEDIS Measures, Medicare Risk Adjustment (MRA ... Review Laboratory and Diagnostic Results and Provide Appropriate Follow-Up Care * Participate in ...
ACN Physician
Debary, FL · On-site
$180K - $210K/yr
Extensive Knowledge of Medicare Advantage Plans, HEDIS Measures, Medicare Risk Adjustment (MRA ... Review Laboratory and Diagnostic Results and Provide Appropriate Follow-Up Care * Participate in ...
Risk Adjustment Coder
Jupiter, FL · On-site
The Risk Adjustment Coder is required to follow procedures and documentation policies regarding ... Travel to offices as necessary to complete on-site chart reviews * Performs post-audits on assigned ...
Risk Adjustment Coder
Jupiter, FL · On-site
The Risk Adjustment Coder is required to follow procedures and documentation policies regarding ... Travel to offices as necessary to complete on-site chart reviews * Performs post-audits on assigned ...
Nurse Practitioner
Miami, FL · On-site
Accurately document HCC (Hierarchical Condition Categories) for MRA (Medicare Risk Adjustment) * Ensure compliance with HEDIS (Healthcare Effectiveness Data and Information Set) performance measures
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Nurse Practitioner
Miami, FL · On-site
Accurately document HCC (Hierarchical Condition Categories) for MRA (Medicare Risk Adjustment) * Ensure compliance with HEDIS (Healthcare Effectiveness Data and Information Set) performance measures
Medicare Risk Adjustment Chart Review information
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 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 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.
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 popular job titles related to Medicare Risk Adjustment Chart Review jobs in Florida?
For Medicare Risk Adjustment Chart Review jobs in Florida, the most frequently searched job titles are:
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:
What cities in Florida are hiring for Medicare Risk Adjustment Chart Review jobs?
Cities in Florida with the most Medicare Risk Adjustment Chart Review job openings:
PBO Risk Adjustment Coding
Fort Lauderdale, FL • On-site
BHC ISC
Other
Re-posted 13 days ago
Job description
Broward Health Corporate ISC
Shift: Shift 1
FTE: 1.000000
Requisition: 31881
Summary: Ensures procedures E&M and diagnoses are coded as documented in the medical records according to ICD-10-CM CPT-4 and HCPCS in an effort to maintain accurate coding and obtain reimbursement all within the professional coding guidelines Centers for Medicare and Medicaid (CMS) guidelines and Broward Health policies. Review and audit documentation for appropriate capture of CAT II coding Medicare Annual Wellness Visits Medicare Risk HRA/HCC Assessment forms Medicare Advantage plans suspect HCC condition forms prior to submission to the payer.
Education: High School or Equivalent
Experience: 2-5 years of risk adjustment coding E/M procedures and diagnosis experience required
Credentials: 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 preferred.
Visit us online at www.BrowardHealth.org or contact Talent Acquisition
*Bonus Exclusions may apply in accordance with policy HR-004-026
Broward Health is proud to be an equal opportunity employer. Broward Health prohibits any policy or procedure which results in discrimination on the basis of race color national origin gender gender identity or gender expression pregnancy sexual orientation religion age disability military status genetic information or any other characteristic protected under applicable federal or state law.
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