Risk Adjustment Coordinator

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🔥 0 minutes ago

🐊 Florida – Remote

🐊 Florida – Remote

💵 $25 - $32 / hour

⏰ Full Time

🟡 Mid-level

🟠 Senior

🎲 Risk

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Baptist Health

WebsiteLinkedInAll Job Openings

10,000+ employees

🏥 Healthcare

🤝 Non-profit

Healthcare • Non-profit

Baptist Health is the region's largest not-for-profit healthcare organization in South Florida. It operates 12 hospitals, more than 29,000 employees, 4,500 physicians, and roughly 200 outpatient centers, urgent care facilities, and physician practices across Miami-Dade, Monroe, Broward, and Palm Beach counties. The system includes renowned centers of excellence in cancer, heart and vascular, brain and spine, and orthopedic care, and is supported by philanthropy and a faith-based mission. Baptist Health emphasizes clinical quality, patient safety, staff development, and community-oriented care.

📋 Description

• Support the Director of risk coding and other team professionals with pre- and post-visit review analysis for provider practices • Provide risk coding education to healthcare providers to improve practice risk scores • Represent the department and health system professionally with co-workers, hospital administrators, physicians, Medicare beneficiaries, and others • Work closely with other departments to achieve favorable outcomes • Perform chart review and up-coding workflows • Coordinate projects to ensure success of goals within the CIN organization • Support the mission, vision, values, and strategic goals of Baptist South Florida

🎯 Requirements

• High School, Cert, GED, Trn, Exper. • Required completion of an accredited certified coding specialist program • AAPC Certified Risk Adjustment Coder (CRC), Certified Professional Coder (CPC), and/or Certified Professional Medical Auditor (CPMA) • CPMA certification must be obtained within 1 year of hire • 2+ years of clinic or hospital experience and/or managed care experience • 1+ years of experience in Risk Adjustment and HEDIS/Stars • Minimum required experience: 5 years • Ability to interpret, analyze, and abstract data/documentation • Comprehensive knowledge of ICD-10-CM codes, Category II codes, COA measures, CMS documentation requirements, state and federal regulations, compliance, reimbursement, and risk-adjustment payment models • Ability to identify HCC improvement opportunities and educate clinical providers on documentation, compliance, and coding guidelines • Intermediate proficiency in MS Office, including Excel, PowerPoint, and Word • Ability to defend coding decisions during internal and external audits • Strong organizational skills and ability to exercise judgment and initiative • Ability to work in a continuously changing environment • Bachelor's of Science degree preferred

🏖️ Benefits

• Career growth and development opportunities, with clear pathways and ongoing support • Comprehensive health and wellness resources • Wellness program that can help employees eliminate their medical plan deductible • Tuition reimbursement