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Work From Home Hcc Risk Adjustment Coding Jobs in Florida

Oscar Health

Auditor, Risk Adjustment

Miami, FL · Remote

$82K - $108K/yr

While your daily work will be completed from your home office, occasional travel may be required ... Review the performance of the Risk Adjustment Coding team and report audit trends to Leadership in ...

Lee Health

Coder II - ProFee Surgery

Cape Coral, FL · On-site +1

$20.50 - $27.85/hr

Coding Work Type: Full Time Shift: Shift 1/8:00:00 AM to 4:30:00 PM Minimum to Midpoint Pay Rate ... Risk Adjustment Coder) • CIC (Certified Inpatient Coder) • CCS (Certified Coding Specialist ...

Lee Health

Coder II - ProFee Surgery

Cape Coral, FL · Remote

$20.50 - $27.85/hr

Coding Work Type: Full Time Shift: Shift 1/8:00:00AM to 4:30:00PM Minimum to Midpoint Pay Rate: $20 ... Risk Adjustment Coder) CIC (Certified Inpatient Coder) CCS (Certified Coding Specialist) RHIT ...

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Work From Home Hcc Risk Adjustment Coding information

See Florida salary details

$11

$20

$32

How much do work from home hcc risk adjustment coding jobs pay per hour?

As of Jul 26, 2026, the average hourly pay for work from home hcc risk adjustment coding in Florida is $20.54, according to ZipRecruiter salary data. Most workers in this role earn between $14.18 and $25.87 per hour, depending on experience, location, and employer.

What is work from home HCC risk adjustment coding?

Work from home HCC (Hierarchical Condition Category) risk adjustment coding involves reviewing medical records and assigning appropriate diagnosis codes to reflect the health status of patients for insurance and Medicare purposes. Coders ensure that all relevant conditions are accurately documented to support proper reimbursement and compliance with regulations. Working remotely allows coders to complete these tasks from home, often using secure online systems provided by their employer. This role requires a solid understanding of medical terminology, coding systems like ICD-10-CM, and risk adjustment models.

What are some common challenges faced by Work From Home HCC Risk Adjustment Coders, and how can they be managed?

Work From Home HCC Risk Adjustment Coders often face challenges such as maintaining consistent productivity, managing complex medical records, and staying current with evolving coding guidelines. Without in-person supervision, it can be difficult to stay focused and avoid distractions, so setting up a dedicated workspace and sticking to a structured schedule is essential. Additionally, regular communication with team members and participating in ongoing training can help coders stay updated and collaborate effectively. Leveraging secure technology for remote access and adhering strictly to HIPAA regulations is also crucial to ensure data privacy and compliance.

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

To thrive as a Work From Home HCC Risk Adjustment Coder, you need a strong understanding of ICD-10-CM coding, knowledge of Hierarchical Condition Categories (HCC), and typically a certification such as CPC or CRC. Familiarity with electronic medical record (EMR) systems and coding software is essential for accurate and efficient code assignment. Attention to detail, self-motivation, and strong communication skills help ensure compliance and productivity in a remote environment. These skills are crucial to ensure accurate risk adjustment coding, which impacts healthcare reimbursement and quality reporting.

What is the difference between Work From Home Hcc Risk Adjustment Coding vs Work From Home Medical Coding Specialist?

AspectWork From Home Hcc Risk Adjustment CodingWork From Home Medical Coding Specialist
CertificationsAHIMA or AAPC HCC certifications, coding credentialsCPH, CPC, or equivalent medical coding certifications
Work EnvironmentRemote, healthcare insurance industryRemote, healthcare or hospital settings
Industry UsageHealth insurance, risk adjustment programsHospitals, clinics, insurance companies
Job FocusRisk adjustment, HCC coding for Medicare/MedicaidGeneral medical coding, billing, and documentation

Work From Home Hcc Risk Adjustment Coding specialists focus on coding for risk adjustment models, primarily in insurance and Medicare programs, requiring specific HCC certifications. In contrast, Work From Home Medical Coding Specialists handle broader medical coding tasks across various healthcare settings. Both roles are remote and require coding credentials, but their industry focus and job responsibilities differ.

What are popular job titles related to Work From Home Hcc Risk Adjustment Coding jobs in Florida? For Work From Home Hcc Risk Adjustment Coding jobs in Florida, the most frequently searched job titles are:
What job categories do people searching Work From Home Hcc Risk Adjustment Coding jobs in Florida look for? The top searched job categories for Work From Home Hcc Risk Adjustment Coding jobs in Florida are:
Work From Home Hcc Risk Adjustment Coding jobs near you
Auditor, Risk Adjustment

Auditor, Risk Adjustment

Oscar Health

Miami, FL • Remote

$82K - $108K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 27 days ago

Oscar Health rating

6.9

Company rating: 6.9 out of 10

Based on 6 frontline employees who took The Breakroom Quiz

247th of 298 rated insurance

Job description

Hi, we're Oscar. We're hiring a Associate, Risk Adjustment Auditor to join our Risk Adjustment team.

Oscar is the first health insurance company built around a full stack technology platform and a relentless focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselves—one that behaves like a doctor in the family.

About the role:

The Associate, Risk Adjustment Auditor conducts internal and external quality audits. Quality audits are specific to ICD-10 code abstraction relative to accuracy, completeness, and identified clinical documentation improvement opportunities. You will work with management to implement benchmarks, establish acceptable thresholds, and quality assurance programs.

You will report into the Manager, Risk Adjustment.

Work Location: This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; or Texas. While your daily work will be completed from your home office, occasional travel may be required for team meetings and company events. #LI-Remote

Pay Transparency: The base pay for this role is: $82,717 - $108,566 per year You are also eligible for employee benefits, participation in Oscar's unlimited vacation program and annual performance bonuses.

Responsibilities:

  • Responsible for daily operations pertaining to Risk Adjustment including but not limited to: medical record reviews to report ICD-10-CM diagnosis codes for ACA and MA lines of business, potential Centers of Medicare & Medicaid Services (CMS), Health and Human Services (HHS) audits and medical record retrieval efforts.
  • Mitigate risk by validating Encounter Data Gathering Environment Server (EDGE) data is supported within provider encounter documentation
  • Review the performance of the Risk Adjustment Coding team and report audit trends to Leadership in a timely, consistent and effective manner to ensure the appropriate changes and education are implemented.
  • Maintain compliance with national standards and coding practices set by the ICD-10-CM coding guidelines for accuracy, as well as compliance with Risk adjustment production standards.
  • Conduct CMS audits of Risk Adjustment activities, including but not limited to Risk Adjustment Data Validation audits.
  • Develop relationships with key individuals to foster an increased understanding of the Risk Adjustment process.
  • Identify and execute on the creation of clinical document improvement resources for provider education in both MA and ACA line of business.
  • Manage the implementation process improvements that will maximize risk adjustment factor increases.
  • Compliance with all applicable laws and regulations
  • Other duties as assigned

Requirements:

  • Bachelor's degree in a relevant field of study or commensurate work experience.
  • Certified professional coder (CPC)
  • 3+ year(s) retrospective risk adjustment coding experience.
  • 1+ year(s) experience Quality Auditing and/or Risk Adjustment Data Validation Audit (RADV) experience

Bonus points:

  • Certified Risk Adjustment Coder (CRC) or similar certification
  • Experience coding in a variety of different Electronic Medical Record (EMR) systems.

This is an authentic Oscar Health job opportunity. Learn more about how you can safeguard yourself from recruitment fraud here.

At Oscar, being an Equal Opportunity Employer means more than upholding discrimination-free hiring practices. It means that we cultivate an environment where people can be their most authentic selves and find both belonging and support. We're on a mission to change health care -- an experience made whole by our unique backgrounds and perspectives.

Pay Transparency: Final offer amounts, within the base pay set forth above, are determined by factors including your relevant skills, education, and experience. Full-time employees are eligible for benefits including: medical, dental, and vision benefits, 11 paid holidays, paid sick time, paid parental leave, 401(k) plan participation, life and disability insurance, and paid wellness time and reimbursements.

Artificial Intelligence (AI): Our AI Guidelines outline the acceptable use of artificial intelligence for candidates and detail how we use AI to support our recruiting efforts.

Reasonable Accommodation: Oscar applicants are considered solely based on their qualifications, without regard to applicant's disability or need for accommodation. Any Oscar applicant who requires reasonable accommodations during the application process should contact the Oscar Benefits Team (accommodations@hioscar.com) to make the need for an accommodation known.

California Residents: For information about our collection, use, and disclosure of applicants' personal information as well as applicants' rights over their personal information, please see our Privacy Policy.

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