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.
Remote Risk-adjustment / HCC coding leader - AI Trainer ($110-$110 per hour) • Carpentersville, Illinois, US
Product Testers are wanted to work from home nationwide in the US to fulfill upcoming contracts with national and international companies.We guarantee 15-25 hours per week with an hourly pay of bet... Show more
AI data lab for training frontier models and evaluating AI agents.Experts contribute their diverse subject matter knowledge across domains such as finance, healthcare, STEM engineering, and more.AI... Show more
Building Code Compliance Expert.Plan review and blueprint reading.AI data lab for training frontier models and evaluating AI agents.Experts contribute their diverse subject matter knowledge across ... Show more
Product Testers are wanted to work from home in the UK to fulfill upcoming contracts with local and international companies.We guarantee 15-25 hours per week with an hourly pay of between £18/hr.Th... Show more
Product Testers are wanted to work from home nationwide in the US to fulfill upcoming contracts with national and international companies.We guarantee 15-25 hours per week with an hourly pay of bet... Show more
AlliedTravelCareers is working with LRS Healthcare to find a qualified CVOR Tech in Rockford, Illinois, 61104!.Ready to start your next travel adventure? LRS Healthcare offers a full benefits packa... Show more
Product Testers are wanted to work from home nationwide in the US to fulfill upcoming contracts with national and international companies.We guarantee 15-25 hours per week with an hourly pay of bet... Show more
At Stability, we have built a nurse friendly platform that simplifies finding travel nursing jobs without the need for a recruiter.We believe in pay transparency and that is why we aggregate thousa... Show more
Product Testers are wanted to work from home nationwide in the US to fulfill upcoming contracts with national and international companies.We guarantee 15-25 hours per week with an hourly pay of bet... Show more
We are seeking experienced and highly accurate Value-Based Coders to join a project dedicated to in-home health assessments for Medicare Advantage and other value-based programs.This role is 100% r... Show more
Product Testers are wanted to work from home nationwide in the US to fulfill upcoming contracts with national and international companies.We guarantee 15-25 hours per week with an hourly pay of bet... Show more
Product Testers are wanted to work from home nationwide in the US to fulfill upcoming contracts with national and international companies.We guarantee 15-25 hours per week with an hourly pay of bet... Show more
AlliedTravelCareers is working with FlexCare to find a qualified CVOR Tech in Rockford, Illinois, 61104!.Call-off Policy Log in to view.First Offer = Best Offer Guaranteed.Comprehensive Benefits Pa... Show more
AlliedTravelCareers is working with Triage Staffing LLC to find a qualified CVOR Tech in Rockford, Illinois, 61101!.Travel Nursing: Cardiovascular OR Tech Rockford.Shift Details: 10H Days (12:00 AM... Show more
At Stability, we have built a nurse friendly platform that simplifies finding travel nursing jobs without the need for a recruiter.We believe in pay transparency and that is why we aggregate thousa... Show more
Looking for people to participate in taking online surveys for Fortune 500 brands.All you need to do is complete online surveys by sharing your opinion.You will help influence brand decisions on se... Show more
AlliedTravelCareers is working with Ventura MedStaff to find a qualified MRI Tech in Rockford, Illinois, 61108!.Are you ready to take your Travel career to the next level? See places you have not ... Show more
Review and label digital content including text, images, and documents.Every task you complete helps improve how technology interprets information and performs in practical settings.Detail-oriented... Show more
Product Testers are wanted to work from home nationwide in the US to fulfill upcoming contracts with national and international companies.We guarantee 15-25 hours per week with an hourly pay of bet... Show more
Product Testers are wanted to work from home nationwide in the US to fulfill upcoming contracts with national and international companies.We guarantee 15-25 hours per week with an hourly pay of bet... Show more
