Actuarial • orange ca
Mercor is working with a leading AI research lab to improve the capabilities of next-generation AI systems.We are seeking experienced Risk Adjustment and HCC Coding leaders to evaluate AI tools des... Show more
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Actuary Job Duties: Interprets financial information to determine forecasts and ... Show more
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Title: System CFO Location: Fountain Valley, CA Department: Administration Status: Full-time Shift: Days Pay Range*: At MemorialCare Health System, we believe in providing extraordinary healthcare ... Show more
Role Overview** - Mercor is seeking senior insurance professionals to build evaluation tasks for AI systems operating in Fortune 500 enterprise insurance and risk contexts.The workflows are calibra... Show more
The Senior Principal Lead Health Actuary Consultant role at Mercer involves managing client projects focused on health benefits strategies, including financial projections and plan design optimizat... Show more
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Assesses risks and makes recommendations for underwriting decisions with support and guidance from leadership as needed, while developing underwriting skills and building critical internal and exte... Show more
Job Title Actuary Location 222 S Harbor Blvd, #720, Anaheim, CA 92805 Salary $80,000 - $150,000/year Position Type Full-time Exempt (Salaried) Monday – Friday 8:.Hybrid after 1 year – 3... Show more
Location: 222 S Harbor Blvd, #720, Anaheim, CA 92805.Salary: $85,000 - $120,000/year.Position Type: Full-Time, Exempt (Salaried), Monday Friday, 8:30 am 5:30 pm, Hybrid after 1 year 3 days in of... Show more
The Senior Underwriter's primary responsibility is to underwrite individual risks through a demonstration of the following skills and abilities:.Fundamentals of coverage, terms and conditions.Abili... Show more
Account Executive (AE), Global.Global Insurance provides tailored insurance solutions for companies based in the United States that do business abroad.Coverage offerings include Property, General L... Show more
Taking care of our customers, our communities and each other.By honoring this commitment, we have maintained our reputation as one of the best property casualty insurers in the industry for over 17... Show more
The average salary range is between $ 90,000 and $ 189,200 year , with the average salary hovering around $ 111,117 year .
The average salary range is between $ 81,325 and $ 159,703 year , with the average salary hovering around $ 107,786 year .
Mercor is working with a leading AI research lab to improve the capabilities of next-generation AI systems. We are seeking experienced Risk Adjustment and HCC Coding leaders to evaluate AI tools designed to improve risk score accuracy and coding completeness in Medicare Advantage, Medicaid managed care, and ACA markets. Your expertise in hierarchical condition category (HCC) methodology, RADV audit preparation, and risk adjustment coding will directly shape AI systems that enhance documentation capture and risk score integrity. **Responsibilities** - Lead risk adjustment and HCC coding operations across Medicare Advantage, Medicaid, and/or ACA risk adjustment programs. - Evaluate AI-generated HCC coding assignments and risk adjustment recommendations for clinical accuracy and regulatory compliance. - Review medical records to ensure complete and accurate capture of HCC-eligible conditions supported by clinical documentation. - Conduct and oversee retrospective and prospective chart reviews for risk score optimisation. - Manage RADV (Risk Adjustment Data Validation) audit preparation and response processes. - Monitor risk adjustment KPIs including HCC capture rates, risk score accuracy, and chart retrieval rates. - Collaborate with clinical, coding, and compliance teams to improve documentation and coding for risk adjustment purposes. - Ensure compliance with CMS risk adjustment guidelines (RAPS, EDGE submissions) and Official Coding Guidelines. - Annotate AI outputs and provide structured coding feedback to support AI training datasets. **Requirements** - 5+ years of experience in risk adjustment coding, HCC coding, or Medicare Advantage coding operations, with at least 2 years in a leadership role. - Deep expertise in CMS-HCC, RxHCC, and/or ACA HHS-HCC risk adjustment methodologies. - Strong knowledge of ICD-10-CM coding guidelines as applied to HCC risk adjustment. - Experience with RADV audit preparation and CMS compliance requirements. - Familiarity with RAPS and EDGE submission processes. - Exceptional written and verbal English communication skills. - High attention to detail with the ability to identify coding inaccuracies and documentation gaps in AI-generated outputs. **Preferred Qualifications** - CRC (Certified Risk Coder), CCS, CPC, or RHIA credential. - Experience with risk adjustment analytics platforms and chart retrieval systems. - Background in health plan, Medicare Advantage organisation, or value-based care setting. - Familiarity with AI-assisted HCC coding tools and comfort evaluating AI-generated risk adjustment content. - Experience presenting risk adjustment performance to actuarial or executive teams. **Why Join?** - Contribute to the development of frontier AI systems in healthcare. - Collaborate with a world-class AI research organisation. - Gain exposure to cutting-edge AI workflows in risk adjustment and value-based care. - Opportunity to work on high-impact projects shaping the future of healthcare AI.
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