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Remote Risk Adjustment Coding Jobs in Hialeah, FL

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Remote Risk Adjustment Coding information

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How much do remote risk adjustment coding jobs pay per hour?

As of Aug 22, 2026, the average hourly pay for remote risk adjustment coding in Hialeah, FL is $19.47, according to ZipRecruiter salary data. Most workers in this role earn between $16.35 and $20.67 per hour, depending on experience, location, and employer.

What is remote risk adjustment coding?

Remote risk adjustment coding is the process of reviewing and assigning medical codes to patient diagnoses and procedures from a remote location, usually at home. The purpose is to ensure that healthcare organizations accurately report the health status of their patients, which affects reimbursement from health plans. Coders use specialized knowledge of ICD-10-CM coding and risk adjustment models, such as HCC (Hierarchical Condition Category) coding, to capture all relevant chronic conditions. This position requires attention to detail, compliance with regulations, and strong analytical skills.

What are the key skills and qualifications needed to thrive as a remote risk adjustment coder?

To thrive as a Remote Risk Adjustment Coder, you need a solid understanding of medical coding, anatomy, and healthcare regulations, typically backed by a coding certification such as CPC, CRC, or CCS. Familiarity with coding software, electronic health record (EHR) systems, and risk adjustment models like HCC is essential. Attention to detail, critical thinking, and strong written communication are crucial soft skills for interpreting clinical documentation and ensuring coding accuracy. These skills and qualifications are vital to accurately capture patient risk, ensure compliance, and optimize reimbursement for healthcare organizations.

How does working remotely as a risk adjustment coder impact collaboration with healthcare teams and ongoing professional development?

As a remote Risk Adjustment Coder, you'll often collaborate with clinical staff, auditors, and other coders through secure digital platforms and regular virtual meetings. While remote work offers flexibility, it also means that proactive communication is essential to ensure accurate coding and compliance with regulations. Many organizations provide virtual training sessions, access to coding forums, and ongoing education to help you stay updated on industry changes and coding standards. Building relationships with your team and participating in online professional communities can further support your growth and help overcome the isolation that sometimes comes with remote work.

What is the difference between Remote Risk Adjustment Coding vs Remote Medical Coding?

AspectRemote Risk Adjustment CodingRemote Medical Coding
CertificationsRHIA, RHIT, CPC, CCSCPC, CCS, CCS-P
Work EnvironmentHealthcare organizations, insurance companiesHospitals, clinics, insurance companies
Industry UsageHealth insurance, risk adjustment programsMedical billing, claims processing

Remote Risk Adjustment Coding focuses on analyzing patient data for insurance risk assessments, requiring specific risk adjustment certifications. Remote Medical Coding involves coding diagnoses and procedures for billing purposes. While both roles require coding certifications, Risk Adjustment Coding emphasizes risk analysis within insurance, whereas Medical Coding centers on billing accuracy.

What are popular job titles related to Remote Risk Adjustment Coding jobs in Hialeah, FL?

For Remote Risk Adjustment Coding jobs in Hialeah, FL, the most frequently searched job titles are:

What job categories do people searching Remote Risk Adjustment Coding jobs in Hialeah, FL look for?

The top searched job categories for Remote Risk Adjustment Coding jobs in Hialeah, FL are:

What cities near Hialeah, FL are hiring for Remote Risk Adjustment Coding jobs?

Cities near Hialeah, FL with the most Remote Risk Adjustment Coding job openings:

Remote Risk Adjustment Coding jobs near you
Infographic showing various Remote Risk Adjustment Coding job openings in Hialeah, FL as of August 2026, with employment types broken down into 100% Full Time. Highlights an 100% Remote job distribution, with an average salary of $40,504 per year, or $19.5 per hour.

Manager, Government Audit

Health Business Solutions LLC

Cooper City, FL • Remote

$95K - $125K/yr

Full-time

Re-posted yesterday

Job description

Position Summary:

HBiz is seeking an experienced and highly organized Manager of Audit to lead all audit-related operations across government, commercial, and post-payment audits. This fully remote role will report directly to the VP of Clinical Appeals and is responsible for overseeing end-to-end audit processes, ensuring regulatory compliance, and managing a team that includes offshore staff. The ideal candidate is a strong communicator, detail-oriented, and comfortable working flexible hours to support coordination across global teams and time zones.

Key Responsibilities:

  • Audit Oversight & Lifecycle Management
    • Lead the management and response process for a variety of audits including RAC, MAC, CERT, PERM, TPE, and commercial payer audits.
    • Oversee case intake, documentation collection, quality review, and timely submission.
    • Track and analyze audit trends, denials, and appeal outcomes to identify risks and recommend improvements.
  • Reporting & Tracking
    • Maintain detailed audit logs and status reports using audit tracking systems.
    • Develop and deliver regular audit performance dashboards and summaries to leadership.
    • Identify audit trends and provide insights for proactive risk mitigation.
  • Team Management & Workflow Coordination
    • Supervise and support a team of audit staff, including managing offshore resources.
    • Assign and coordinate cases with clinical, coding, technical, and documentation teams.
    • Ensure efficient workflows and balanced workloads across team members.
    • Work flexible hours when needed to support offshore operations and tight deadlines.
  • Collaboration Across Departments
    • Act as the liaison between clinical, coding, HIM, compliance, and IT teams for audit support.
    • Ensure audit responses include accurate, complete, and compliant documentation.
    • Facilitate escalation and resolution of complex audit issues.
  • Compliance & Quality Assurance
    • Ensure all audit activity complies with CMS, commercial payer, and regulatory requirements.
    • Support policy and process development to strengthen audit readiness and response.
    • Participate in internal audits and risk assessments as needed.

Qualifications:

  • Bachelor’s degree in Health Information Management, Healthcare Administration, Business, or related field (Master’s preferred).
  • Minimum 5 years of healthcare audit experience, including government and post-payment audits.
  • At least 2 years in a supervisory or leadership role, including managing remote/offshore staff.
  • In-depth understanding of audit regulations, payer requirements, and healthcare reimbursement.
  • Familiarity with medical coding (ICD-10, CPT, HCPCS), billing practices, and clinical documentation standards.
  • Excellent communication, organizational, and leadership skills.
  • Proficient with audit tracking software, EHRs, and Microsoft Office Suite.

The ideal candidate is articulate, organized, detail-oriented, and able to adjust their schedule as needed to engage with teams across a global network and multiple time zones.

Acts as a liaison between internal Hbiz clients, (i.e.: coding, HIM, compliance, and IT teams); as well as external clients we are supporting with our services.


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