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Risk Adjustment Coder Job in Sunrise, Florida

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Job Title: Risk Adjustment Coder

Employer:Amicus Medical Group
Preferred Certifications:CPC and/or CRC
Location:1300 Concorde Terrace, Suite 210 Sunrise 33323, FL, US
Date Posted:1/22/2021


Responsible for reviewing medical records and identifying, collecting, assessing, monitoring and documenting claims and encounter coding information as it pertains to Clinical Condition Categories.


  • Performs on-site and remote clinical validation audits and interpretation of medical documentation to ensure capture of all relevant coding in coordination with the physician.
  • Verifies and ensures the accuracy, completeness, specificity and appropriate coding based on CMS HCC categories.
  • Analyses and translates medical and clinical diagnoses, procedures, injuries, and  illnesses into designated numerical codes.
  • Reviews medical records, patient medical history and physical exams, physician orders, progress notes, consultation reports, diagnostic reports, operative and pathology reports, and discharge summaries.
  • Performs ongoing analysis of medical charts for appropriate coding compliance.
  • Ensures compliance with all applicable Federal, State, and/or County laws and regulations related to coding and documentation guidelines.
  • Communicates with co-workers, management and clinic staff regarding reimbursement issues.
  • Provides support and compliance with each HEDIS specification through effective communication and training/education.
  • Maintains established departmental policies and procedures, objectives, safety, environmental, and infection control standards.
  • Participates in departmental and organizational quality management activities.
  • Cooperates with other personnel to achieve department objectives and maintain good employee relations, and interdepartmental objectives.
  • Attends departmental meetings as required.
  • Effectively manage special projects and other tasks as assigned.
  • Performs other duties as required.

REQUIREMENTS (including, but not limited to):

  • Ability to travel to several sites located in Miami-Dade, Broward, and Palm Beach county on a daily basis.
  • Associate's Degree or equivalent training or experience required.
  • Minimum, two (2) years experience in a physician practice or in a Medical Center required.
  • Proficient in ICD-10 coding and strong knowledge of ICD-9 and CPT coding.
  • Requires critical thinking skills, decisive judgment and the ability to work with minimal supervision.
  • Must be a reliable team player committed to working in a quality and customer centric environment.  Will require daily interaction in person, on the phone, and via email in order to perform the job.
  • Superior customer service skills: demonstrate responsiveness, depth of knowledge and thoroughness in handling and responding to inquiries from patients and team members.
  • Skilled in harmoniously working in high stress situations/environments and with distraught or agitated individuals.
  • Ability to work autonomously, to multi-task, and provide quality patient care is essential.  
  • Self-reliant and self-motivated with strong ability to prioritize and plan to get things done.
  • Ability to work productively, cohesively within a team and resolve conflict in a positive manner.
  • Adaptability is essential to manage the needs of a department with unpredictable volume and resources.
  • Exceptional interpersonal skills, flexible, outgoing, with a professional “can-do” attitude.
  • Excellent listening comprehension, oral communication, and written communication skills and the ability to interact in a tactful and positive manner.
  • Able to follow oral and written instructions precisely and keen attention to detail and high degree of accuracy.
  • Able to read, write, and understand English.  Bilingual - Spanish or Creole is a plus.
  • Understanding and experience using EMR software and applications.
  • Proficient computer skills and solid knowledge of Microsoft Office products (Outlook, Excel, Word, etc.).
  • Ability to safely and successfully perform the essential job functions consistent with the ADA and other federal, state and local standards, including meeting qualitative and/or quantitative productivity standards.

In addition to the above listed minimum requirements, candidates who possess the following skills, experience, and capabilities may receive greater consideration during the evaluation process:

  • Experience in Geriatrics
  • Experience with a health plan/health insurer and/or Medicare/Medicaid


Please follow link below to apply.


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