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Remote Hcc Risk Adjustment Coder Jobs in Miami, FL

Actalent

Pediatric Case Manager

Fort Lauderdale, FL · On-site +1

$40 - $44/hr

Remote Pediatric Case Manager Role! The Pediatric Case Manager plays a crucial role in managing ... Conduct outreach to high-risk members and provide disease-specific education. * Empower patients ...

Worth AI

Data Platform Engineer

Miami, FL · Remote

$117K - $140K/yr

CI/CD, containerization (Docker), orchestration (Kubernetes), and infrastructure-as-code (Terraform ... for risk detection ** All Remote Hires - will be required to travel to Orlando, Florida at least ...

Worth AI

Data Platform Engineer

Miami, FL · On-site +1

$109K - $131K/yr

CI/CD, containerization (Docker), orchestration (Kubernetes), and infrastructure-as-code (Terraform ... for risk detection ** All Remote Hires - will be required to travel to Orlando, Florida at least ...

Ramp

Customer Activation Manager | Enterprise

Miami, FL · Remote

$147K - $262K/yr

... risk, categorizing spend, and closing books. The problems are high-stakes, data-dense, and ... You don't need to code, but credibility in technical conversations is what earns you a seat at the ...

Worth AI

Quality Assurance (QA) Engineer

Miami, FL · On-site +1

Present concise test reports and risk analyses to stakeholders, highlighting critical issues and ... Conduct thorough regression and integration testing after each code change to verify fixes and ...

Invivyd

Strategic Account Manager, Miami

Miami, FL · On-site +1

... risk for severe COVID-19, including stem cell and solid organ transplant patients as well as those ... Remote (Miami) Position Summary: At Invivyd, we're building a new category of infectious disease ...

BillionToOne

Account Executive

Miami, FL · Remote

$184K - $248K/yr

Responsibilities: * Increasing utilization of UNITY Fetal Risk Screen and driving market ... Demonstrated values and ethics that support BillionToOne's mission, goals, and professional code of ...

Humana

Senior Cybersecurity Engineer

Miami, FL · Remote

$109K - $150K/yr

Perform risk assessments, follow and enhance the security solutions lifecycle (evaluation, purchase ... Additional Information Remote/WAH requirements: * WAH requirements: Must have the ability to ...

Humana

Senior Cybersecurity Engineer

Miami, FL · Remote

$109K - $150K/yr

Perform risk assessments, follow and enhance the security solutions lifecycle (evaluation, purchase ... Additional Information Remote/WAH requirements: * WAH requirements: Must have the ability to ...

New

ProSidian Consulting

Transportation Engineer (FTA5)

Miami, FL · On-site +1

$74K - $98K/yr

CONUS - Charlotte, NC, Miami, FL, Washington, DC (Remote) to provide Transportation Sector related ... Code: 541611 - Administrative Management and General Management Consulting Services for the two ...

Humana

Senior Cybersecurity Engineer

Miami, FL · Remote

$109K - $150K/yr

Perform risk assessments, follow and enhance the security solutions lifecycle (evaluation, purchase ... Additional Information Remote/WAH requirements: * WAH requirements: Must have the ability to ...

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All JobsRemote Hcc Risk Adjustment Coder JobsRemote Hcc Risk Adjustment Coder Jobs in Miami, FL

Remote Hcc Risk Adjustment Coder information

See Miami, FL salary details

$15

$21

$32

How much do remote hcc risk adjustment coder jobs pay per hour?

As of Jun 21, 2026, the average hourly pay for remote hcc risk adjustment coder in Miami, FL is $21.45, according to ZipRecruiter salary data. Most workers in this role earn between $17.26 and $22.98 per hour, depending on experience, location, and employer.

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

To thrive as a Remote HCC Risk Adjustment Coder, you need a solid understanding of ICD-10-CM coding guidelines, risk adjustment models, and extensive experience in medical record review, typically supported by a relevant coding certification such as CPC or CRC. Proficiency with electronic health record (EHR) systems, coding software, and risk adjustment platforms is essential. Exceptional attention to detail, analytical thinking, and strong communication skills help coders excel in remote settings and ensure coding accuracy. These skills and qualifications are vital for optimizing risk scores, ensuring compliance, and supporting accurate reimbursement in healthcare organizations.

What is a Remote HCC Risk Adjustment Coder?

A Remote HCC Risk Adjustment Coder is a medical coding professional who works from home or another remote location, reviewing patient medical records to assign Hierarchical Condition Category (HCC) codes. These codes are used by healthcare organizations to accurately reflect the severity of patient illnesses for risk adjustment and reimbursement purposes, especially in Medicare Advantage programs. The coder analyzes clinical documentation to ensure that diagnoses are coded correctly and in compliance with regulatory guidelines. Their work is essential for ensuring healthcare providers receive appropriate compensation and for maintaining accurate patient risk profiles.

What are some common challenges faced by remote HCC Risk Adjustment Coders and how can they be managed?

Remote HCC Risk Adjustment Coders often encounter challenges such as interpreting incomplete or ambiguous medical documentation, staying updated with evolving coding guidelines, and managing communication across dispersed teams. To address these challenges, it's important to proactively seek clarification from providers, participate in ongoing training, and utilize collaboration tools to stay connected with peers and supervisors. Establishing a structured daily workflow and leveraging available resources can also help maintain coding accuracy and productivity in a remote setting.
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Remote Hcc Risk Adjustment Coder jobs near you
Director, Post Pay Audit

Director, Post Pay Audit

Health Business Solutions LLC

Cooper City, FL • Remote

Full-time

Posted 8 days ago

Job description

Job Summary:

We are seeking a highly experienced and strategic Director of Post-Pay Audit to lead our medical revenue recovery audit teams across both onshore (U.S.) and offshore (Philippines) operations. This leader will be responsible for overseeing the execution of comprehensive post-payment audits across commercial and government payers (Medicare, Medicaid, TRICARE, etc.), ensuring compliance, accuracy, and maximum revenue recovery for healthcare provider clients.

The ideal candidate brings deep knowledge of healthcare reimbursement policies, government audit programs (e.g., RAC, UPIC, MAC), and a proven ability to lead cross-functional and cross-cultural teams at scale.

Key Responsibilities:

  • Lead and manage the end-to-end post-pay audit function, including planning, execution, quality assurance, and reporting.
  • Direct and support a global team of audit professionals, ensuring productivity, accuracy, and compliance across both U.S.-based and Philippines-based operations.
  • Oversee audit processes related to government payers and regulatory programs (e.g., CMS RAC, Medicaid Integrity Program, etc.).
  • Establish and refine audit workflows, KPIs, and escalation protocols to optimize audit yield and recovery timelines.
  • Collaborate with compliance, legal, and analytics teams to identify audit opportunities and mitigate risk.
  • Serve as the subject matter expert for payer audit guidelines, CMS regulations, and state-specific requirements.
  • Build strong relationships with internal stakeholders and clients to align audit strategies with broader revenue recovery goals.
  • Develop and execute training programs and professional development plans for onshore and offshore audit staff.
  • Ensure adherence to internal quality standards, HIPAA regulations, and client-specific SLAs.
  • Analyze audit outcomes and present regular performance and risk reports to senior leadership.

Qualifications:

  • Bachelor’s degree in Healthcare Administration, Business, Finance, or related field required; Master’s or MBA preferred
  • Minimum of 7–10 years of experience in post-payment auditing, healthcare reimbursement, or revenue recovery
  • Proven experience managing global teams, including operations based in the Philippines
  • Strong knowledge of government audit programs (RAC, MAC, CERT, ZPIC/UPIC, Medicaid audits)
  • Excellent understanding of healthcare billing, coding (ICD-10, CPT, HCPCS), and payer policies
  • Demonstrated ability to lead process improvement initiatives in large-scale audit operations
  • High proficiency with audit and recovery systems, reporting tools, and workflow platforms
  • Strong communication, leadership, and analytical skills
  • Certification in auditing, billing, or compliance (e.g., CPMA, CPC, CHC) is a plus

Health Business Solutions (HBiz) is an Equal Opportunity Employer. We are committed to providing equal employment opportunities to all employees and applicants without regard to race, color, religion, sex (including pregnancy, sexual orientation, or gender identity), national origin, age, disability, genetic information, veteran status, or any other status protected by applicable federal, state, or local law.

HBiz complies with all applicable employment laws for remote and multi-state hiring and provides reasonable accommodations as required by law.

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