Medicare Risk Adjuster

At MedFlorida Medical Centers, we are a fast-growing organization that specializes in providing exceptional patient-centered primary care services. Our goal is to improve the health, happiness, and well-being of each patient, with a commitment to excellence in all that we do.

If your goal is to be part of an agile and collaborative team that is dedicated to patient care, look no further, this opportunity is meant for YOU!

MedFlorida offers competitive salaries, medical, dental and vision insurance, paid time off, and 6 paid public holidays, and stock grants for qualified outstanding employees.

**This is an on-site position, no remote option available, you may choose between our Deerfield Beach and Miami Lakes locations**

The Medicare Risk Adjuster (MRA) supports Med Florida Medical Centers by preparing the Provider’s assessment the day before the visit with all MRA/HCC relevant codes based on the evidence found in the patient’s medical history, data warehouse, dropped conditions and other insurance documents provided. The role of each Medicare Risk Adjuster (MRA) is to complete patient medical chart evaluation to maximize the quality of the MRA/HCC coding.

A. Essential Duties

• Audit patient medical history for their scheduled appointment the day prior and submit documentation to assigned provider.
• Review, evaluate, and complete with accuracy the patient progress notes with all appropriate MRA/HCC/ICD10 Guidelines and CPT codes.
• Analyze patient history to create preventative recommendations.
• Ability to accurately recognize and recommend all applicable quality measures.
• Generate clinical recommendations based on patient’s medical history and conditions.
• Post reviews all notes audited no later than ten (10) days after the date of service.
• Communicate effectively with multiple departments including, but not limited to, Revenue Cycle Management.
• Coordinate with assigned provider’s a monthly meeting to review reccomendations.
• Organize, evaluate, and communicate data analysis report with supervisor and applicable departments.

B. Additional Duties

1. Assists and covers other staff when necessary to maintain high productivity and efficiency in the department.

2. As the company continues to grow, additional responsibilities that are essential for the department to be successful will be assigned accordingly.

Education:

1. Foreign Medical Degree is preffered.

2. Health care or related field experience is highly desirable. A comparable amount of experience would be acceptable.

3. Certified Professional Coder (CPC) or Certified Risk Adjustment Coder (CRC) or comparable certification is highly desirable.

4. Certified Medical Professional Auditor (CMPA) is highly desired.

Experience

1. Previous experience as a Medicare Risk Adjuster is required.

2. Medical Terminology is required.

3. ICD-10 and CPT codes knowledge is required.

4. Knowledge of government CMS regulatory requirements is preferred.

5. Computer literate: Microsoft Office (Excel, Word, and PowerPoint) required.

6. eClinicalWorks electronic medical records system knowledge a plus.

Bilingual is preferred