Medicare Risk Adjustment Educator — Hybrid Impact

Cano Health; Miami, Northern (FL, KY); Hybrid; USD 95,000 - 125,000; Full time

Benefits offered by this job

Hybrid work arrangement

Travel opportunities

Job summary

Cano Health in Miami, FL is seeking a Medicare Risk Adjustment Educator to support its Medicare Advantage and ACO Reach programs. The role partners with providers, affiliated practices, and clinical teams to improve risk adjustment accuracy through education, documentation review, and guidance.

You will review charts, train staff, and lead onboarding and retraining programs, ensuring regulatory compliance and optimal patient care.

Qualifications

• Bachelor’s degree in healthcare, nursing, or a related field.
• CPC certification from AAPC or AHIMA equivalent.
• Additional AAPC certifications (CRC, CPMA, CDEO) preferred.
• Minimum 3 years in Clinical Documentation Improvement or related roles (risk adjustment coding).
• 5+ years in coding and billing (ICD-10, CPT, HCPCS).

Responsibilities

• Review clinical documentation for completeness and alignment with Medicare Risk Adjustment (HCC) coding guidelines.
• Coordinate and conduct timely educational sessions with providers and staff, including scheduling, material preparation, follow-up documentation, and storage.
• Identify gaps in documentation and provide real-time guidance to improve accuracy and compliance.
• Clarify clinical conditions with providers to ensure accurate coding of chronic conditions and co-morbidities.
• Abstract clinical data and accurately assign appropriate ICD-10-CM codes.
• Conduct onboarding and retraining programs for providers, affiliates, and coding staff.
• Perform regular chart audits to monitor compliance and identify opportunities for improvement.
• Maintain expertise on CMS regulations, risk adjustment methodologies, and coding updates.
• Collaborate with quality assurance, coding, and operations teams to refine documentation workflows.
• Develop and implement training materials, tools, and best practices to improve risk adjustment documentation processes.

Skills

Analytical skills

Regulatory knowledge

Education & training

Interpersonal communication

Bilingual English/Spanish

Education

Bachelor’s degree in healthcare / related field

CPC certification (AAPC)

Additional AAPC certifications (CRC CPMA CDEO)

Foreign medical degree a plus

Tools

Excel

PowerPoint

Job description

Cano Health in Miami, FL is seeking a Medicare Risk Adjustment Educator to support its Medicare Advantage and ACO Reach programs. The role partners with providers, affiliated practices, and clinical teams to improve risk adjustment accuracy through education, documentation review, and guidance.

You will review charts, train staff, and lead onboarding and retraining programs, ensuring regulatory compliance and optimal patient care.