Review and audit documentation for appropriate capture of CAT II coding Medicare Annual Wellness ... High School or Equivalent 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 or Equivalent 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 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 ... 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 ...
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 ...
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 ...
Auditor, Risk Adjustment
Miami, FL · Remote
$82K - $108K/yr
We're hiring a Associate, Risk Adjustment Auditor to join our Risk Adjustment team. Oscar is the ... Medicare & Medicaid Services (CMS), Health and Human Services (HHS) audits and medical record ...
Quick apply
Auditor, Risk Adjustment
Miami, FL · Remote
$82K - $108K/yr
We're hiring a Associate, Risk Adjustment Auditor to join our Risk Adjustment team. Oscar is the ... Medicare & Medicaid Services (CMS), Health and Human Services (HHS) audits and medical record ...
Manager Risk Adjustment Program
Tampa, FL · On-site +1
Two (2) or more years of experience in a lead risk adjustment role working with OR for Medicare Advantage health plans. *Any equivalent combination of education and experience that provides the ...
Manager Risk Adjustment Program
Tampa, FL · On-site +1
Two (2) or more years of experience in a lead risk adjustment role working with OR for Medicare Advantage health plans. *Any equivalent combination of education and experience that provides the ...
ACN Physician
Debary, FL · On-site
$180K - $210K/yr
The Ideal Candidate Should Have a Proven Track Record of Working with Medicare Advantage Patients and Be Well-Versed in HEDIS Quality Measures, Medicare Risk Adjustment (MRA), RAF Score Optimization ...
ACN Physician
Debary, FL · On-site
$180K - $210K/yr
The Ideal Candidate Should Have a Proven Track Record of Working with Medicare Advantage Patients and Be Well-Versed in HEDIS Quality Measures, Medicare Risk Adjustment (MRA), RAF Score Optimization ...
ACN Physician
Debary, FL · On-site
$210K/yr
The Ideal Candidate Should Have a Proven Track Record of Working with Medicare Advantage Patients and Be Well-Versed in HEDIS Quality Measures, Medicare Risk Adjustment (MRA), RAF Score Optimization ...
ACN Physician
Debary, FL · On-site
$210K/yr
The Ideal Candidate Should Have a Proven Track Record of Working with Medicare Advantage Patients and Be Well-Versed in HEDIS Quality Measures, Medicare Risk Adjustment (MRA), RAF Score Optimization ...
ACN Physician
$180K - $210K/yr
The Ideal Candidate Should Have a Proven Track Record of Working with Medicare Advantage Patients and Be Well-Versed in HEDIS Quality Measures, Medicare Risk Adjustment (MRA), RAF Score Optimization ...
ACN Physician
$180K - $210K/yr
The Ideal Candidate Should Have a Proven Track Record of Working with Medicare Advantage Patients and Be Well-Versed in HEDIS Quality Measures, Medicare Risk Adjustment (MRA), RAF Score Optimization ...
ACN Physician
$180K - $210K/yr
The Ideal Candidate Should Have a Proven Track Record of Working with Medicare Advantage Patients and Be Well-Versed in HEDIS Quality Measures, Medicare Risk Adjustment (MRA), RAF Score Optimization ...
ACN Physician
$180K - $210K/yr
The Ideal Candidate Should Have a Proven Track Record of Working with Medicare Advantage Patients and Be Well-Versed in HEDIS Quality Measures, Medicare Risk Adjustment (MRA), RAF Score Optimization ...
Deep understanding of Medicare Advantage, CMS regulations, HEDIS, Star Ratings, and Medicare Risk Adjustment (HCC coding). * Strong knowledge of value-based care models, ACO operations, and managed ...
Deep understanding of Medicare Advantage, CMS regulations, HEDIS, Star Ratings, and Medicare Risk Adjustment (HCC coding). * Strong knowledge of value-based care models, ACO operations, and managed ...
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 ... risk adjustment, and ensures accuracy, • Completeness, specificity and appropriateness of ...
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 ... risk adjustment, and ensures accuracy, • Completeness, specificity and appropriateness of ...
Medical Risk Adjustment Coder- VBC
$17.50 - $23.50/hr
... for Medicare/Medicare Advantage and ACO health plan members. • Reviews medical records and ... Certified Risk Adjustment Coder (CRC) Experience • Prior HCC/HHS experience with Medicare Risk ...
Medical Risk Adjustment Coder- VBC
$17.50 - $23.50/hr
... for Medicare/Medicare Advantage and ACO health plan members. • Reviews medical records and ... Certified Risk Adjustment Coder (CRC) Experience • Prior HCC/HHS experience with Medicare Risk ...
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
Quick apply
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
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 ... AAPC Certified Risk Adjustment Coder. * AAPC Certified Professional Coder. * AAPC Certified ...
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 ... AAPC Certified Risk Adjustment Coder. * AAPC Certified Professional Coder. * AAPC Certified ...
The position will support ambulatory division including Health Point in establishing Medicare Risk Adjustment, Medical Coding and Billing compliance, Healthcare auditing of documentation, revenue ...
The position will support ambulatory division including Health Point in establishing Medicare Risk Adjustment, Medical Coding and Billing compliance, Healthcare auditing of documentation, revenue ...
Risk Adjustment Coordinator, Remote, Baptist Health Integrated Care, FT, 08A-4:30P
Boca Raton, FL · On-site +1
$25.37 - $32.22/hr
... Medicare beneficiaries, and others to represent the department and the health system while working ... AAPC Certified Risk Adjustment Coder. * AAPC Certified Professional Coder. * AAPC Certified ...
Risk Adjustment Coordinator, Remote, Baptist Health Integrated Care, FT, 08A-4:30P
Boca Raton, FL · On-site +1
$25.37 - $32.22/hr
... Medicare beneficiaries, and others to represent the department and the health system while working ... AAPC Certified Risk Adjustment Coder. * AAPC Certified Professional Coder. * AAPC Certified ...
Medicare Risk Adjustment information
See Florida salary details
$9.52 - $11.38
16% of jobs
$11.86 is the 25th percentile. Wages below this are outliers.
$11.38 - $13.24
34% of jobs
$13.24 - $15.11
18% of jobs
$15.11 - $16.97
1% of jobs
$17.95 is the 75th percentile. Wages above this are outliers.
$16.97 - $18.83
10% of jobs
$18.83 - $20.69
4% of jobs
$20.69 - $22.55
3% of jobs
$22.55 - $24.41
2% of jobs
$24.41 - $26.28
9% of jobs
$26.28 - $28.14
0% of jobs
$28.14 - $30
2% of jobs
$9
$16
$29
How much do medicare risk adjustment jobs pay per hour?
As of Aug 22, 2026, the average hourly pay for medicare risk adjustment in Florida is $16.75, according to ZipRecruiter salary data. Most workers in this role earn between $12.02 and $20.29 per hour, depending on experience, location, and employer.
What is Medicare Risk Adjustment?
Medicare Risk Adjustment is a process used by the Centers for Medicare & Medicaid Services (CMS) to adjust payments to Medicare Advantage plans based on the health status and demographic characteristics of their enrolled beneficiaries. The goal is to ensure that plans receive appropriate compensation for taking care of members with varying levels of health risk. This system uses diagnosis codes and other data to predict future healthcare costs, encouraging plans to provide comprehensive care and accurately document patient conditions.
What are jobs in Medicare Risk Adjustment?
Jobs in Medicare risk adjustment include work in data analytics, consulting, insurance, and closely related industries. Your duties and responsibilities differ depending on the type of work. For example, as a Medicare risk-adjustment consultant, you provide advice and recommendations to healthcare organizations or an insurance provider on how to mitigate risk across a customer pool. Data analytics and statistics specialists gather and analyze insurance and Medicare data and documentation from hospitals, healthcare providers, and other medical care facilities that accept Medicare. This includes reviewing different types of diagnosis and comparing patient chart information. Some health care providers have in-house risk adjustment workers, while others contract with outside consulting and analytics firms.
What are the key skills and qualifications needed to thrive in Medicare Risk Adjustment?
To excel in Medicare Risk Adjustment, you need a solid understanding of medical coding (especially ICD-10), healthcare regulations, and risk adjustment methodologies, often supported by credentials like CRC or CPC certifications. Familiarity with data analytics platforms, EHR systems, and specialized risk adjustment software is typically required. Strong attention to detail, analytical thinking, and effective communication are crucial soft skills for interpreting complex clinical data and collaborating across teams. These competencies ensure accurate risk scores, compliance with CMS requirements, and optimal financial outcomes for healthcare organizations.
What are some common challenges faced by professionals working in Medicare Risk Adjustment roles?
Professionals in Medicare Risk Adjustment often encounter challenges such as staying current with frequently changing CMS regulations, ensuring the accurate capture and documentation of patient diagnoses, and collaborating effectively with providers to optimize risk scores. The role requires meticulous attention to detail when reviewing medical records and coding, as well as strong communication skills to educate and support healthcare teams. Additionally, there can be pressure to meet strict deadlines for data submission and to ensure compliance with audit standards.
What is the difference between Medicare Risk Adjustment vs Medicare Coding Specialist?
| Aspect | Medicare Risk Adjustment | Medicare Coding Specialist |
|---|---|---|
| Primary Focus | Assessing patient health risk scores for reimbursement | Accurately coding medical diagnoses and procedures |
| Required Credentials | Certifications in risk adjustment or coding, often CPC or RHIT | Certifications like CPC, CCS, or RHIT |
| Work Environment | Health plans, risk adjustment companies, healthcare providers | Hospitals, clinics, billing departments |
| Industry Usage | Used for Medicare Advantage plan reimbursements | Used for medical billing and claims processing |
While both roles involve healthcare coding and require similar certifications, Medicare Risk Adjustment focuses on evaluating patient health data to determine reimbursement levels, whereas Medicare Coding Specialists concentrate on accurately coding diagnoses and procedures for billing purposes.
More about Medicare Risk Adjustment jobs
What are the most commonly searched types of Medicare Risk Adjustment jobs in Florida?
The most popular types of Medicare Risk Adjustment jobs in Florida are:
What are popular job titles related to Medicare Risk Adjustment jobs in Florida?
For Medicare Risk Adjustment jobs in Florida, the most frequently searched job titles are:
What job categories do people searching Medicare Risk Adjustment jobs in Florida look for?
The top searched job categories for Medicare Risk Adjustment jobs in Florida are:
What cities in Florida are hiring for Medicare Risk Adjustment jobs?
Cities in Florida with the most Medicare Risk Adjustment job openings:
Broward Health rating
6.9
Based on 91 frontline employees who took The Breakroom Quiz
456th of 891 rated healthcare providers
Job description
Coding Specialist
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.
High School or Equivalent
2-5 years of risk adjustment coding E/M procedures and diagnosis experience required. 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.
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. At Broward Health the dedication and contributions of veterans are valued. Supporting the military community and giving back to those who served is a priority. Broward Health is proud to offer veteran's preference in the hiring process to eligible veterans and other individuals as defined by applicable law.
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About Broward Health
Sourced by ZipRecruiter
A career with Broward Health means endless opportunities to grow through a wide range of experiences across the healthcare system. You will be part of a team that is continually raising the bar for patient care. Our competitive benefits package includes healthcare coverage, a matching retirement program, pension plan, and wellness programs.
Industry
Hospitals
Company size
5,001 - 10,000 Employees
Headquarters location
Fort Lauderdale, FL, US
Year founded
1938