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Medicare Risk Adjustment Jobs in Florida (NOW HIRING)

TEKsystems

HCC Coder - Fully Remote

Jacksonville, FL · Remote

$32 - $37/hr

... risk adjustment Medicare, ACA Commercial and Medicaid models Demonstrated ability to apply critical thinking skills to coding policy interpretation and implementation. Experience providing written ...

PedIM Healthcare

HCC Coder

Lecanto, FL

$13.75 - $18.50/hr

Strong knowledge of CMS risk adjustment methodology and Medicare Advantage models * Active coding credential preferred (CRC, CPC, CCS, or equivalent) * Proven experience with chart audits and ...

Pedim

HCC Coder

Lecanto, FL · On-site

$13.75 - $18.50/hr

Strong knowledge of CMS risk adjustment methodology and Medicare Advantage models * Active coding credential preferred (CRC, CPC, CCS, or equivalent) * Proven experience with chart audits and ...

PedIM Healthcare

HCC Coder

Lecanto, FL · On-site

$13.75 - $18.50/hr

Strong knowledge of CMS risk adjustment methodology and Medicare Advantage models * Active coding credential preferred (CRC, CPC, CCS, or equivalent) * Proven experience with chart audits and ...

Pedim

HCC Coder

Lecanto, FL · On-site

$13.75 - $18.50/hr

Strong knowledge of CMS risk adjustment methodology and Medicare Advantage models * Active coding credential preferred (CRC, CPC, CCS, or equivalent) * Proven experience with chart audits and ...

MASC Medical

Primary Care Physician

Bradenton, FL · On-site

$190 - $230/hr

Training on accurate risk adjustment coding * Training on Medicare appropriate quality of care (STARS) program * Must take call once week every 6 weeks Primary Care Physician - Responsibilities

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Medicare Risk Adjustment information

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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?

AspectMedicare Risk AdjustmentMedicare Coding Specialist
Primary FocusAssessing patient health risk scores for reimbursementAccurately coding medical diagnoses and procedures
Required CredentialsCertifications in risk adjustment or coding, often CPC or RHITCertifications like CPC, CCS, or RHIT
Work EnvironmentHealth plans, risk adjustment companies, healthcare providersHospitals, clinics, billing departments
Industry UsageUsed for Medicare Advantage plan reimbursementsUsed 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:

Medicare Risk Adjustment jobs near you
Infographic showing various Medicare Risk Adjustment job openings in Florida as of August 2026, with employment types broken down into 1% As Needed, 86% Full Time, 10% Part Time, and 3% Contract. Highlights an 87% Physical, 5% Hybrid, and 8% Remote job distribution, with an average salary of $34,848 per year, or $16.8 per hour.

Advanced Practice Registered Nurse

Integrity Placement Group

Debary, FL • On-site

$90K - $130K/yr

Full-time

PTO

Re-posted 10 days ago

Job description

Advanced Practice Registered Nurse (APRN)

The Company:

Our Client is a Growing, Patient-Centered Primary Care Practice Located in DeBary, Florida. We are Committed to Providing High-Quality, Compassionate Healthcare with a Strong Focus on Preventive Medicine, Chronic Disease Management, and Improving Health Outcomes for Medicare Advantage Patients.

The Position:

Our Client is Actively Seeking an Experienced Advanced Practice Registered Nurse (APRN) who is Fluent in Both English and Spanish and has Extensive Experience Caring for Medicare Advantage Patients.

The Ideal Candidate is Passionate About Primary Care, Value-Based Medicine, and Delivering Exceptional Patient Care While Helping Improve Quality Metrics, Patient Satisfaction, and Overall Healthcare Outcomes.

Compensation & Benefits:

  • Competitive Salary: $90,000 – $130,000 (Based on Experience)
  • Paid Time Off (PTO)
  • Paid Holidays
  • Supportive & Collaborative Work Environment
  • Opportunity to Grow with a Rapidly Expanding Practice

Requirements:

  • Master's Degree in Nursing from an Accredited Program
  • Current, Unrestricted Florida APRN License
  • National Board Certification as a Family Nurse Practitioner (FNP) or Equivalent
  • Current BLS and ACLS Certifications
  • Fluent in Both English and Spanish
  • Minimum of Two (2) Years of Experience in Primary Care, Family Medicine, Internal Medicine, or Geriatrics
  • Extensive Knowledge of Medicare Advantage Plans, HEDIS Measures, Risk Adjustment (RAF), and Value-Based Care
  • Strong Clinical, Communication, and Organizational Skills
  • Experience Utilizing eClinicalWorks (eCW) Electronic Medical Records Preferred

Responsibilities:

  • Full-Time Monday – Friday 8 am - 5 pm
  • No Nights, No Weekends
  • Provide Comprehensive Primary Care Services to Adult and Geriatric Patients
  • Perform Annual Wellness Visits (AWVs) and Preventive Health Screening
  • Diagnose and Manage Acute and Chronic Medical Conditions Including Diabetes, Hypertension, COPD, Heart Disease, and Other Complex Illnesses
  • Accurately Document Patient Encounters to Support Medicare Advantage and Risk Adjustment Initiatives
  • Monitor and Address HEDIS Measures, Quality Metrics, and Preventive Care Gaps
  • Coordinate Care with Specialists, Hospitals, Home Health Agencies, and Other Healthcare Providers
  • Educate Patients and Families Regarding Diagnoses, Treatment Plans, Medications, and Preventive Health Strategies
  • Review Laboratory and Diagnostic Results and Provide Appropriate Follow-Up Care
  • Participate in Quality Improvement Initiatives and Value-Based Care Programs
  • Collaborate with Physicians, Nurses, and Administrative Staff to Ensure Exceptional Patient Care

Please Apply HERE or Send Resume to Cherri@theipgteam.com

Integrity Placement Group logo

About Integrity Placement Group

Sourced by ZipRecruiter

Integrity Placement Group, based in Sarasota, Florida, United States, is a distinguished player in the healthcare recruitment sector. Their specialty lies in finding the most suited professionals for medical, nursing, and executive roles in the healthcare industry. They are reputed for their precision placement, which results from a refined process of understanding both the prospective candidates and the hiring organization’s values and expectations. The company's mission is to help healthcare organizations achieve their goals by providing qualified candidates who align with their culture and values. Their site, integrityplacementgroup.com, is considered a key portal for healthcare professionals seeking career growth and companies in need of recruitment solutions.

Industry

Recruiting and staffing services

Company size

11 - 50 Employees

Headquarters location

Sarasota, FL, US

Year founded

2017

Social media

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