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Optum Health Coding Risk Adjustment Jobs in Florida

Oscar Health

Auditor, Risk Adjustment

Miami, FL · Remote

$82K - $108K/yr

Oscar is the first health insurance company built around a full stack technology platform and a ... Quality audits are specific to ICD-10 code abstraction relative to accuracy, completeness, and ...

Msmc

Certified Risk Adjustment Coder Senior

Miami Beach, FL

$22.25 - $30.25/hr

CC019053 Population Health Clinical Ops Summary: Position Responsibilities * Demonstrates knowledge of coding and documentation standards as well as CMS Risk Adjustment Program guidelines and HCCs ...

Lee Health

HCC Coding Educator

Fort Myers, FL · On-site +1

$27.57 - $35.84/hr

Associate's degree in health information management, nursing, healthcare administration or related field required. Experience: Minimum of 3 years' experience in HCC coding and risk adjustment.

Lee Health

HCC Coding Educator

Fort Myers, FL · Remote

$27.57 - $35.84/hr

Associates degree in health information management, nursing, healthcare administration or related field required. Experience: Minimum of 3 years experience in HCC coding and risk adjustment. Minimum ...

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Optum Health Coding Risk Adjustment information

What are the typical daily responsibilities of an Optum Health Coding Risk Adjustment specialist?

On a daily basis, Optum Health Coding Risk Adjustment specialists review medical records to identify and accurately code diagnoses, ensuring completeness and compliance with risk adjustment requirements. They collaborate closely with clinical teams and other coders to clarify documentation and resolve discrepancies. The role often involves conducting chart audits, submitting coding queries, and staying updated on the latest coding guidelines and regulatory changes. Attention to deadlines and maintaining data quality are key parts of the job, making it both detail-oriented and highly collaborative.

What is an Optum Health Coding Risk Adjustment job?

An Optum Health Coding Risk Adjustment job involves reviewing medical records to assign appropriate diagnosis codes that impact risk adjustment programs. These coders ensure accurate documentation of chronic conditions to support healthcare reimbursement models. They work with providers to improve coding accuracy and compliance with regulatory guidelines. Strong knowledge of ICD-10-CM coding, risk adjustment models, and healthcare regulations is essential.

What are the key skills and qualifications needed to thrive in the Optum Health Coding Risk Adjustment position, and why are they important?

To thrive as an Optum Health Coding Risk Adjustment professional, you need a strong understanding of ICD-10-CM coding, risk adjustment methodologies, and medical terminology, often supported by certifications like CPC, CRC, or CCS-P. Familiarity with electronic medical record (EMR) systems, coding software, and compliance tools is essential. Attention to detail, analytical thinking, and effective communication are valuable soft skills in this role. These competencies ensure accurate coding, regulatory compliance, and optimal risk adjustment, directly impacting healthcare quality and reimbursement.

What are the most commonly searched types of Optum Health Coding Risk Adjustment jobs in Florida? The most popular types of Optum Health Coding Risk Adjustment jobs in Florida are:
What are popular job titles related to Optum Health Coding Risk Adjustment jobs in Florida? For Optum Health Coding Risk Adjustment jobs in Florida, the most frequently searched job titles are:
What job categories do people searching Optum Health Coding Risk Adjustment jobs in Florida look for? The top searched job categories for Optum Health Coding Risk Adjustment jobs in Florida are:
Optum Health Coding Risk Adjustment jobs near you

Risk Adjustment Analyst

PCC MEDICAL HOLDINGS LLC

North Palm Beach, FL • On-site

$65K - $75K/yr

Full-time

Posted 12 days ago

Job description

Risk Adjustment Specialist – Primary Care
Location: Remote
Employment Type: Full-Time
Pay : $65K - $75K
About Us
Here at Physician Care Centers, we are a patient-centered primary care organization committed to delivering high-quality, value-based care. Our team partners with providers to improve patient outcomes while ensuring accurate clinical documentation and coding practices.
Position Overview
We are seeking a detail-oriented Risk Adjustment Specialist to support our value-based care initiatives. In this role, you will work closely with providers and clinical teams to ensure accurate documentation and coding of patient conditions, helping reflect the true complexity of our patient population.
What You’ll Do
  • Perform pre-visit and post-visit chart reviews to identify risk adjustment opportunities
  • Ensure accurate ICD-10-CM and HCC coding based on clinical documentation
  • Partner with providers to clarify diagnoses and improve documentation quality
  • Educate providers and staff on risk adjustment and coding best practices
  • Track and monitor Risk Adjustment Factor (RAF) scores and performance metrics
  • Support internal and external audits and ensure compliance with Centers for Medicare & Medicaid Services (CMS) guidelines
  • Stay current on coding updates and value-based care requirements
What We’re Looking For
  • 2+ years of experience in risk adjustment, medical coding, or primary care
  • Strong knowledge of ICD-10-CM and HCC coding
  • Certification such as CRC or CPC preferred
  • Experience working with electronic health records (EHRs)
  • Excellent attention to detail and analytical skills
  • Strong communication skills and ability to collaborate with providers
Why Join Us?
  • Competitive salary and benefits package
  • Opportunity to work in a growing value-based care environment
  • Collaborative and supportive team culture
  • Professional development and certification support