AIDS Healthcare Foundation

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Risk Adjustment Coder

Risk Adjustment Coder

Req No 
Job Locations 
US-FL-Ft. Lauderdale
Managed Care
Regular Full-Time

More information about this job


PHP is a Medicare Advantage Prescription Drug health plan specifically for Medicare beneficiaries who are living with HIV and reside in Duval, Broward and Miami-Dade Counties.
PHP is the first HIV-specific special needs health plan approved by the Centers for Medicare & Medicaid Services (CMS). This plan covers routine doctor and specialist office visits, emergency and urgent care, hospitalization, and more. It also includes a prescription drug benefit for no monthly premium.
PHC Florida
PHC Florida is a Medicaid managed care plan designed specifically for HIV-positive individuals who are eligible for Medicaid and live in Broward, Miami-Dade and Monroe Counties.  PHC Florida is a Managed Medical Assitance (MMA) plan offered through Florida’s statewide Medicaid Managed Care Program



Does the idea of doing something that really makes a difference in people’s lives while being well-compensated intrigue you? Are you looking to work for an organization that encourages growth and success from each and every one of its employees?


If so, AIDS Healthcare Foundation is the place for you!


Founded in 1987, AIDS Healthcare Foundation is the largest specialized provider of HIV/AIDS medical care in the nation. Our mission is to provide cutting edge medicine and advocacy, regardless of ability to pay. Through our healthcare centers, pharmacies, health plan, research and other activities, AHF provides access to the latest HIV treatments for all who need them.


AHF’s core values are:


• Patient-Centered

• Value Employees

• Respect for Diversity

• Nimble

• Fight for What’s Right


STILL INTERESTED? Please continue!


The Risk Adjustment Coder (RAC) contributes to AHF's mission by providing medical coding knowledge pertaining to the Managed Care Risk Adjustment Model in PHP SNP.


The Risk Adjustment Coder must be friendly, thorough, professional and timely in assisting in special coding projects related to coding of medical charts in the Risk Adjustment department. The individual is responsible for overall coordination of all such medical records retrieval requests & processes, and work with external network providers in a professional and courteous manner, and upheld the mission, vision values of AHF.


The RAC continually contributes to the success of AHF Health plans by  performing medial record reviews and abstraction of ICD-10 codes effectively from medical records for the purpose of ensuring quality and timely care of the Health Plan’s members according to CMS risk adjustment guidelines. The RAC is responsible for collecting, assessing, monitoring and documenting encounter coding information as it pertains to Hierarchical Condition Category Codes classification; and to verify and ensure the accuracy, completeness, specificity and appropriateness of diagnosis codes based on the documentation of services rendered.


In addition, this position will also help the RA Coding team to meet risk adjustment coding deadlines for various internal coding projects.


The RAC maintains quality of work by obtaining and maintaining the Medical Coding Certification and applies that knowledge of coding, documentation standards, state and federal regulations and correct coding guidelines in his/her daily work and education of others on medical coding standards.



We at AIDS Healthcare Foundation believe that each individual is entitled to equal employment opportunities without regard to race, color, creed, gender, sexual orientation, gender identity, marital status, national origin, age, veteran status or disability. The right of equal employment opportunity extends to recruiting, hiring selection, transfer, promotion, training and all other conditions of employment.