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Remote Flexible Risk Adjustment Coder Jobs in Florida

Phsorg

Analyze the impact of risk adjustment models, acuity shifts, redeterminations and eligibility churn ... Flexible spending accounts (FSAs) * Free wellness programs * Paid time off (PTO) * Retirement plans ...

Alignerr

Professional Voice Actor - French

Miami, FL · Remote

This is a fully remote, flexible contract role for seasoned voice talent. No AI background needed ... Review scripts and suggest adjustments to enhance clarity and ensure authentic, natural-sounding ...

Huntington

Portfolio/Risk Specialist

Tampa, FL · On-site +1

$93K/yr

... flexible work arrangement. We're combining the best of both worlds: in-office and work from home ... Remote roles will also have the opportunity to come together in our offices for moments that matter.

Huntington

Portfolio/Risk Specialist

Tampa, FL · On-site +1

$92K/yr

... flexible work arrangement. We're combining the best of both worlds: in-office and work from home ... Remote roles will also have the opportunity to come together in our offices for moments that matter.

Phsorg

Strong understanding of claims data, risk adjustment methodologies, and Health Plan financial ... Flexible spending accounts (FSAs) * Free wellness programs * Paid time off (PTO) * Retirement plans ...

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Remote Flexible Risk Adjustment Coder information

What are the key skills and qualifications needed to thrive as a Remote Flexible Risk Adjustment Coder, and why are they important?

To thrive as a Remote Flexible Risk Adjustment Coder, you need a strong grasp of medical coding standards (ICD-10-CM), risk adjustment models, and a certification such as CPC, CRC, or CCS. Proficiency with coding software, EHR systems, and secure remote communication tools is typically required. Attention to detail, time management, and strong analytical and communication skills help ensure accuracy and effective remote collaboration. These skills are vital for precise coding, regulatory compliance, and supporting accurate healthcare reimbursements in a remote work environment.

What is the difference between Remote Flexible Risk Adjustment Coder vs Remote Risk Adjustment Coder?

AspectRemote Flexible Risk Adjustment CoderRemote Risk Adjustment Coder
CertificationsAHIMA or AAPC certifications, CPC or CCSSame certifications as flexible role
Work EnvironmentFlexible hours, remote workPrimarily remote, with some flexibility
Employer UsageHealth plans, insurance companies, healthcare providersSimilar employer types, often overlapping
Search IntentFlexible scheduling, remote work optionsGeneral risk adjustment coding roles

The Remote Flexible Risk Adjustment Coder offers more scheduling flexibility compared to the standard Remote Risk Adjustment Coder, while both roles require similar credentials and are used in comparable healthcare settings. The flexible role is ideal for those seeking adaptable hours within the same industry.

How does a Remote Flexible Risk Adjustment Coder typically collaborate with healthcare providers and other coding professionals?

As a Remote Flexible Risk Adjustment Coder, collaboration often occurs through secure digital platforms, regular virtual meetings, and shared documentation tools. You may work closely with healthcare providers to clarify medical records and ensure coding accuracy, as well as coordinate with other coders to maintain consistency and compliance. Strong communication skills and responsiveness are essential, as much of the interaction is asynchronous and relies on clear documentation. This teamwork helps ensure accurate risk adjustment coding, supporting healthcare organizations in meeting regulatory and reimbursement standards.

What is a Remote Flexible Risk Adjustment Coder?

A Remote Flexible Risk Adjustment Coder is a healthcare professional who reviews and assigns diagnostic codes to patient records from a remote location, often with flexible hours. Their main role is to ensure that medical diagnoses are accurately captured for risk adjustment purposes, which helps healthcare organizations receive appropriate reimbursement from insurers. They typically analyze electronic health records, identify relevant conditions, and code them based on established guidelines. This job requires knowledge of medical terminology, coding systems like ICD-10, and a strong attention to detail. Working remotely allows for a flexible schedule, making it a popular option for experienced coders.
What are popular job titles related to Remote Flexible Risk Adjustment Coder jobs in Florida? For Remote Flexible Risk Adjustment Coder jobs in Florida, the most frequently searched job titles are:
What job categories do people searching Remote Flexible Risk Adjustment Coder jobs in Florida look for? The top searched job categories for Remote Flexible Risk Adjustment Coder jobs in Florida are:
What cities in Florida are hiring for Remote Flexible Risk Adjustment Coder jobs? Cities in Florida with the most Remote Flexible Risk Adjustment Coder job openings:
Remote Flexible Risk Adjustment Coder jobs near you
Risk & Quality Performance Manager (Remote)

Risk & Quality Performance Manager (Remote)

Molina Healthcare

Tampa, FL • Remote

$66K - $129K/yr

Full-time

Posted 28 days ago

Molina Healthcare rating

8.0

Company rating: 8.0 out of 10

Based on 192 frontline employees who took The Breakroom Quiz

146th of 260 rated insurance

Job description

Job Description


Job Summary

The Risk & Quality Performance Manager position will support Molina's Risk & Quality Solutions (RQS) team. This position collaborates with various departments and stakeholders within Molina to plan, coordinate, and manage resources and execute performance improvement initiatives in alignment with RQS's strategic objectives.

Job Duties

 Collaborate with Health Plan Risk and Quality leaders to improve outcomes by managing Risk/Quality data collection strategy, analytics, and reporting, including but not limited to: Risk/Quality rate trending and forecasting; provider Risk/Quality measure performance, CAHPS and survey analytics, health equity and SDOH, and engaging external vendors. 
 Monitor projects from inception through successful delivery.
 Oversee Risk/Quality data ingestion activities and strategies to optimize completeness and accuracy of EHR/HIE and supplemental data.
 Meet customer expectations and requirements, establish, and maintain effective relationships and gain their trust and respect.
 Draw actionable conclusions, and make decisions as needed while collaborating with other teams.
 Ensure compliance with all regulatory audit guidelines by adhering to roadmap of deliverables and timelines and implementing solutions to maximize national HEDIS audit success.
 Partner with other teams to ensure data quality through sequential transformations and identify opportunities to close quality and risk care gaps.
 Proactively communicate risks and issues to stakeholders and leadership.
 Create, review, and approve program documentation, including plans, reports, and records.
 Ensure documentation is updated and accessible to relevant parties.
 Proactively communicate regular status reports to stakeholders, highlighting progress, risks, and issues.

Job Qualifications

REQUIRED EDUCATION:

Bachelor's degree or equivalent combination of education and experience

REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES:

2+ years of program and/or project management experience in risk adjustment and/or quality
 2+ years of experience supporting HEDIS engine activity, risk adjustment targeting and reporting systems
 2+ years of data analysis experience utilizing technical skillsets and resources to answer nuanced Risk and Quality questions posed from internal and external partners
 Familiarity with running queries in Microsoft Azure or SQL server
 Healthcare experience and functional risk adjustment and/or quality knowledge
 Mastery of Microsoft Office Suite including Excel and Project
 Experience partnering with various levels of leadership across complex organizations
 Strong quantitative aptitude and problem solving skills
 Intellectual agility and ability to simplify and clearly communicate complex concepts
 Excellent verbal, written and presentation capabilities
 Energetic and collaborative

PREFERRED EDUCATION:

Graduate degree or equivalent combination of education and experience

PREFERRED EXPERIENCE:

 Knowledge of, and familiarity with, NCQA, CMS, and State regulatory submission requirements
 Experience working in a cross-functional, highly matrixed organization
 SQL proficiency
 Knowledge of healthcare claim elements: CPT, CPTII, LOINC, SNOMED, HCPS, NDC, CVX, NPIs, TINs, etc.
PREFERRED LICENSE, CERTIFICATION, ASSOCIATION:

PMP, Six Sigma Green Belt, Six Sigma Black Belt Certification, and/or comparable coursework desired

#PJCorp

#LI-AC1

To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Pay Range: $66,456 - $129,590 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Employment Type: Full Time

What Molina Healthcare employees say

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Hours and flexibility

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About Molina Healthcare

Sourced by ZipRecruiter

Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Long Beach, CA, US

Year founded

1980

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