Risk Adjustment Coordinator, Remote

Baptist Health is the region's largest not-for-profit healthcare organization, with 12 hospitals, over 29,000 employees, 4,500 physicians and 200 outpatient centers, urgent care facilities and physician practices across Miami-Dade, Monroe, Broward and Palm Beach counties. With internationally renowned centers of excellence in cancer, cardiovascular care, orthopedics and sports medicine, and neurosciences, Baptist Health is supported by philanthropy and driven by its faith-based mission of medical excellence. For 26 years, we've been named one of Fortune's 100 Best Companies to Work For, and in the 2025-2026 U.S. News & World Report Best Hospital Rankings, Baptist Health was the most awarded healthcare system in South Florida, earning 63 high-performing honors.

What truly sets us apart is our people. At Baptist Health, we create personal connections with our colleagues that go beyond the workplace, and we form meaningful relationships with patients and their families that extend beyond delivering care. Many of us have walked in our patients' shoes ourselves and that shared experience fuels out commitment to compassion and quality. Our culture is rooted in purpose, and every team member plays a part in making a positive impact – because when it comes to caring for people, we're all in.

At Baptist Health, we’re committed to supporting our employees at every stage of their journey, both personally and professionally. Our approach is rooted in a “grow our own” philosophy, designed to help our team members build meaningful, long-term careers with us, supported by benefits that make a real difference, including:

• Career growth and development opportunities, with clear pathways and ongoing support
• Comprehensive health and wellness resources that go beyond traditional benefits
• A wellness program that can help employees eliminate their medical plan deductible, reducing out-of-pocket healthcare costs
• Tuition reimbursement to support continued learning and advancement
• And so much more

Together, these benefits and others reflect our commitment to caring for our people, so they can build fulfilling careers with us while making a meaningful impact every day.

Description:

The Risk coding Regional Auditor must support the Director of risk coding along with other team professionals working to provide pre and post visit review analysis for provider practices while providing risk coding education to healthcare providers to improve practice risk scores. He or she must relate in a professional manner to co-workers, hospital administrators, physicians, Medicare beneficiaries, and others to represent the department and the health system while working closely with other departments to achieve favorable outcomes. This position is responsible for chart review and up-coding workflows. The position will also require coordination of projects to ensure the success of the goals within the CIN organization. Supports the mission, vision, values and strategic goals of Baptist South Florida. Estimated pay range for this position is $25.37 - $32.22 / hour depending on experience.

Qualifications:

Degrees:

• High School,Cert,GED,Trn,Exper.

Licenses & Certifications:

• AAPC Certified Risk Adjustment Coder.
• AAPC Certified Professional Coder.
• AAPC Certified Professional Medical Auditor.

Additional Qualifications:

• Bachelors of Science degree preferred.
• Certified Professional Coder and/ or Certified Risk Adjustment Coder (CRC).
• CPMA certification must be obtained within 1 year of Hire.
• Required completion of an accredited certified coding specialist program.
• 2+ years of clinic or hospital experience and/ or managed care experience.
• 1+ years of experience in Risk Adjustment and HEDIS/Stars.
• 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 including compliance and reimbursement and the impact of diagnosis coding on risk adjustment payment models.
• Ability to identify HCC improvement opportunities and educate clinical providers on proper clinical documentation, compliance, and coding guidelines.
• Intermediate level of proficiency in MS Office – Excel, PowerPoint, and Word.
• Ability to defend coding decisions to both internal and external audits.
• Strong organizational skills in multiple settings, as well as the ability to exercise judgement and initiative.
• Ability to work in a continuously changing environment.

Minimum Required Experience: 5 Years

EOE, including disability/vets