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 ...
Auditor, ACO Coding
Miami, FL · On-site
$26 - $29.75/hr
CPC, CRC, CCS-P, CCS-H, RHIT * 3+ years of Medicare Risk Adjustment experience * Experience working in health care and insurance Industry. Education Requirements Required/Preferred Education Level ...
Auditor, ACO Coding
Miami, FL · On-site
$26 - $29.75/hr
CPC, CRC, CCS-P, CCS-H, RHIT * 3+ years of Medicare Risk Adjustment experience * Experience working in health care and insurance Industry. Education Requirements Required/Preferred Education Level ...
Auditor, ACO Coding
Miami, FL · On-site
$26 - $29.75/hr
CPC, CRC, CCS-P, CCS-H, RHIT * 3+ years of Medicare Risk Adjustment experience * Experience working in health care and insurance Industry. Education Requirements Required/Preferred Education Level ...
Auditor, ACO Coding
Miami, FL · On-site
$26 - $29.75/hr
CPC, CRC, CCS-P, CCS-H, RHIT * 3+ years of Medicare Risk Adjustment experience * Experience working in health care and insurance Industry. Education Requirements Required/Preferred Education Level ...
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 ...
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 ...
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
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 ...
Provider Education Specialist
Miami, FL · On-site
Demonstrated expertise in risk adjustment, HCC documentation, and Medicare Advantage programs * Strong understanding of value-based care models and Clinical Documentation Improvement (CDI) principles
Quick apply
Provider Education Specialist
Miami, FL · On-site
Demonstrated expertise in risk adjustment, HCC documentation, and Medicare Advantage programs * Strong understanding of value-based care models and Clinical Documentation Improvement (CDI) principles
... VBP), risk adjustment models, quality metrics such as Healthcare Effectiveness Data and Information Set (HEDIS) and Medicare STARS, and coding. • Knowledge of medical economics and financial ...
... VBP), risk adjustment models, quality metrics such as Healthcare Effectiveness Data and Information Set (HEDIS) and Medicare STARS, and coding. • Knowledge of medical economics and financial ...
... VBP), risk adjustment models, quality metrics such as Healthcare Effectiveness Data and Information Set (HEDIS) and Medicare STARS, and coding. • Knowledge of medical economics and financial ...
... VBP), risk adjustment models, quality metrics such as Healthcare Effectiveness Data and Information Set (HEDIS) and Medicare STARS, and coding. • Knowledge of medical economics and financial ...
Knowledge of value- based programs (VBP), risk adjustment models, quality metrics such as Healthcare Effectiveness Data and Information Set (HEDIS) and Medicare STARS, and coding. Knowledge of ...
Knowledge of value- based programs (VBP), risk adjustment models, quality metrics such as Healthcare Effectiveness Data and Information Set (HEDIS) and Medicare STARS, and coding. Knowledge of ...
Director, Value-Based Programs (Value-Based Contracting & (CMS LAN) Remote in FL
Fort Lauderdale, FL · Remote
... VBP), risk adjustment models, quality metrics such as Healthcare Effectiveness Data and Information Set (HEDIS) and Medicare STARS, and coding. • Knowledge of medical economics and financial ...
Director, Value-Based Programs (Value-Based Contracting & (CMS LAN) Remote in FL
Fort Lauderdale, FL · Remote
... VBP), risk adjustment models, quality metrics such as Healthcare Effectiveness Data and Information Set (HEDIS) and Medicare STARS, and coding. • Knowledge of medical economics and financial ...
MEDICAL CODING SPECIALIST
Coral Gables, FL · On-site
$20 - $25/hr
Support managed care processes, including risk adjustment, quality initiatives, and utilization ... Experience working with managed care plans, including Medicare Advantage and other payer models
Quick apply
MEDICAL CODING SPECIALIST
Coral Gables, FL · On-site
$20 - $25/hr
Support managed care processes, including risk adjustment, quality initiatives, and utilization ... Experience working with managed care plans, including Medicare Advantage and other payer models
Primary Care Physician (MD/DO)
Weston, FL · On-site
Participate in quality improvement initiatives, clinical meetings, and value-based care programs, including HEDIS, Medicare Advantage, and Risk Adjustment initiatives. * Ensure compliance with all ...
Quick apply
Primary Care Physician (MD/DO)
Weston, FL · On-site
Participate in quality improvement initiatives, clinical meetings, and value-based care programs, including HEDIS, Medicare Advantage, and Risk Adjustment initiatives. * Ensure compliance with all ...
Primary Care Physician (MD/DO)
Miami, FL · On-site
Participate in quality improvement initiatives, clinical meetings, and value-based care programs, including HEDIS, Medicare Advantage, and Risk Adjustment initiatives. * Ensure compliance with all ...
Primary Care Physician (MD/DO)
Miami, FL · On-site
Participate in quality improvement initiatives, clinical meetings, and value-based care programs, including HEDIS, Medicare Advantage, and Risk Adjustment initiatives. * Ensure compliance with all ...
Participate in quality improvement initiatives, clinical meetings, and value-based care programs, including HEDIS, Medicare Advantage, and Risk Adjustment initiatives. * Ensure compliance with all ...
Participate in quality improvement initiatives, clinical meetings, and value-based care programs, including HEDIS, Medicare Advantage, and Risk Adjustment initiatives. * Ensure compliance with all ...
Primary Care Physician (MD/DO)
Miami, FL · On-site
Participate in quality improvement initiatives, clinical meetings, and value-based care programs, including HEDIS, Medicare Advantage, and Risk Adjustment initiatives. * Ensure compliance with all ...
Quick apply
Primary Care Physician (MD/DO)
Miami, FL · On-site
Participate in quality improvement initiatives, clinical meetings, and value-based care programs, including HEDIS, Medicare Advantage, and Risk Adjustment initiatives. * Ensure compliance with all ...
Medicare Risk Adjustment information
See Miami, FL salary details
$12.19 - $14.57
16% of jobs
$15.18 is the 25th percentile. Wages below this are outliers.
$14.57 - $16.95
34% of jobs
$16.95 - $19.33
18% of jobs
$19.33 - $21.72
1% of jobs
$22.97 is the 75th percentile. Wages above this are outliers.
$21.72 - $24.10
10% of jobs
$24.10 - $26.48
4% of jobs
$26.48 - $28.87
3% of jobs
$28.87 - $31.25
2% of jobs
$31.25 - $33.63
9% of jobs
$33.63 - $36.01
0% of jobs
$36.01 - $38.40
2% of jobs
$12
$21
$38
How much do medicare risk adjustment jobs pay per hour?
As of Sep 2, 2026, the average hourly pay for medicare risk adjustment in Miami, FL is $21.44, according to ZipRecruiter salary data. Most workers in this role earn between $15.38 and $25.96 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 Miami, FL?
The most popular types of Medicare Risk Adjustment jobs in Miami, FL are:
What are popular job titles related to Medicare Risk Adjustment jobs in Miami, FL?
For Medicare Risk Adjustment jobs in Miami, FL, the most frequently searched job titles are:
What job categories do people searching Medicare Risk Adjustment jobs in Miami, FL look for?
The top searched job categories for Medicare Risk Adjustment jobs in Miami, FL are:
What cities near Miami, FL are hiring for Medicare Risk Adjustment jobs?
Cities near Miami, FL with the most Medicare Risk Adjustment job openings:
Other
This job post has expired today. Applications are no longer accepted.
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.
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.