Florida Licensed Risk Adjustment Coder

Job Summary

To support the Burden of Illness department, the full-time Florida Licensed Risk Adjustment Coder will conduct coding reviews, validate provider documentation, and ensure accurate risk adjustment coding in a remote setting.

Key responsibilities

• Perform prospective medical record reviews to ensure accurate coding
• Conduct concurrent outpatient claim diagnosis coding and quality assurance validation
• Execute retrospective medical record and provider response reviews to reconcile documentation

Required qualifications

• Active Florida Licensed Risk Adjustment Coder certification
• Experience with medical coding and risk adjustment processes
• Knowledge of clinical documentation requirements and coding guidelines
• Proficiency in medical record review and quality assurance practices
• Familiarity with outpatient claim coding and diagnosis coding systems