Hybrid Risk Adjustment Nurse/Coder (RN/CPC) – Remote/Onsite

Sentara Health; Town of Florida (NY); Hybrid; USD 71,000 - 109,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Vision insurance

401k/403B match

Paid time off

Job summary

Sentara Health AvMed division in Florida is seeking a Risk Adjustment Nurse/Coder for a hybrid role in Doral, FL. The position requires 2 years of medical coding experience, relevant certifications, and familiarity with ICD-10-CM and RADV processes.

It involves audits, coding reviews, and vendor oversight, with two onsite days and three remote days, M-F, 8am–4:30pm EST. Base pay range is $71,177.60–$108,534.40 annually with comprehensive benefits.

Qualifications

• Associate degree in healthcare administration, nursing, health information management, accounting, finance, or related field.
• Certifications: RN preferred or CPC/COC/CIC/CCS-P/CCS/RHIT/RHIA; CRC certification within 2 years.

Responsibilities

• Perform CMS/HHS Risk Adjustment coding for professional and inpatient/outpatient services.
• Conduct RADV audits and medical record reviews; ensure accurate HCC capture.
• Coordinate risk adjustment gap elimination with clinical and quality teams; vendor QC oversight.

Skills

ICD-10-CM knowledge

CMS/HHS RADV experience

Paper/electronic medical records

Education

Associate degree or higher in healthcare related field

Tools

N/A

Job description

Sentara Health AvMed division in Florida is seeking a Risk Adjustment Nurse/Coder for a hybrid role in Doral, FL. The position requires 2 years of medical coding experience, relevant certifications, and familiarity with ICD-10-CM and RADV processes.

It involves audits, coding reviews, and vendor oversight, with two onsite days and three remote days, M-F, 8am–4:30pm EST. Base pay range is $71,177.60–$108,534.40 annually with comprehensive benefits.