Talent.com
Mercor
Remote Risk-adjustment / HCC coding leader - AI Trainer ($110-$110 per hour)Mercor • Pico Rivera, California, US
Remote Risk-adjustment / HCC coding leader - AI Trainer ($110-$110 per hour)

Remote Risk-adjustment / HCC coding leader - AI Trainer ($110-$110 per hour)

Mercor • Pico Rivera, California, US
30+ days ago
Job type
  • Full-time
  • Remote
Job description
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.
Create a job alert for this search

Remote Risk-adjustment / HCC coding leader - AI Trainer ($110-$110 per hour) • Pico Rivera, California, US

Similar jobs

Information Technology Professional

US NavyAltadena, CA, US
Full-time

Information Technology Professional (IT/CTN/IS).Information Systems Technicians, Cryptologic Technician Networks, and Intelligence Specialists keep the Fleet connected, informed, and secure by oper... Show more

 • Promoted

Clinical Supervisor- Board Certified Behavior Analyst (BCBA)- Remote

360 Behavioral HealthAltadena, CA, United States
Remote
Full-time

Who are we?360 Behavioral Health provides exceptional care for individuals with autism and developmental delays.With over 30 years of expertise, we are a leading authority in ABA-based behavioral h... Show more

 • Promoted

Clinical Trial Participants Needed - Earn Up to $4,000 Part-Time

Apex Focus Group LLCAltadena, CA, United States
Part-time

Looking to earn extra income while contributing to medical advancements? Explore local clinical trials and get paid up to $4,000 for your participation.No-cost study-related care and medication pro... Show more

 • Promoted

Online Survey Participant: Work Remote and Earn Up To $25 Per Survey

Earn HausAltadena, CA, US
Remote
Full-time +1

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

 • Promoted

Flexible remote AI work. Your schedule. Paid weekly, straight to your bank account.

Meridian.aiAltadena, CA, US
Remote
Full-time

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

 • Promoted

Senior Data Analyst | HR & Compensation Team (Remote Southern California)

Veritas Search GroupAltadena, CA, United States
Remote
Full-time

This role requires candidates who are currently authorized to work in the U.C2C arrangements are not accepted.While this role is primarily remote, you must live in Southern California due to occasi... Show more

 • Promoted

Survey Taker: Earn up to $25 per survey (Remote)

Earn HausAltadena, CA, US
Remote
Full-time +1

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

 • Promoted

Tax Preparer In-Store

IntuitMount Wilson, CA, United States
Full-time

Intuit is seeking highly motivated individuals to join our dynamic team as a dedicated Tax Associate - TurboTax Store in one of our new TurboTax locations across the United States on a seasonal bas... Show more

 • Promoted

Cost Engineer Hybrid-Remote Level 1,2 and 3 (Los Angeles)

PM2CM IncAltadena, CA, United States
Remote
Full-time

Project Management to Construction Management) is a professional services company dedicated to providing Program and Project Management, Construction Management and Project Controls services during... Show more

 • Promoted

Complete Online Surveys For Cash (Up to $25/per)

Earn HausAltadena, CA, US
Full-time +1

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

 • Promoted

Tax Expert - TurboTax Store

IntuitAltadena, CA, United States
Full-time

Intuit is seeking highly motivated individuals to join our dynamic team as a dedicated Tax Expert - TurboTax Store in one of our new TurboTax locations across the United States on a seasonal basis.... Show more

 • Promoted

Experienced Tax Expert In-Store

IntuitAltadena, CA, United States
Full-time

Intuit is seeking highly motivated individuals to join our dynamic team as a dedicated Tax Expert - TurboTax Store in one of our new TurboTax locations across the United States on a seasonal basis.... Show more

 • Promoted

Remote Product Tester - Flexible Studies

BuzzTestersValyermo, CA
Remote
Full-time

Earn up to $400/week, depending on the number and type of studies you complete.Share honest feedback on products and services from independent brands.Assignments include short online surveys (10–20... Show more

 • Promoted

Audit Senior Remote Home Based & Hybrid Work Schedule

HR Talent AllianceAltadena, CA, United States
Remote
Full-time

Audit Senior - Assurance and Advisory Services -Remote - Home Based / Hybrid Schedule AvaialbleWell established highly profitable regional CPA firm seeks an Audit Senior to specialize in exciting d... Show more

 • Promoted

Earn Cash From Taking Surveys Online

Earn HausAltadena, CA, US
Full-time +1

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

 • Promoted

Retail Tax Expert

IntuitMount Wilson, CA, United States
Full-time

Intuit is seeking highly motivated individuals to join our dynamic team as a dedicated Tax Expert - TurboTax Store in one of our new TurboTax locations across the United States on a seasonal basis.... Show more

 • Promoted

Coding Audit Director (Full-Time, Remote)

GeBBS Healthcare SolutionsAltadena, CA, United States
Remote
Full-time

Coding Audit Director (Full-Time, Remote)2 days ago Be among the first 25 applicantsDescriptionDirector - Internal & External Coding Audits GeBBS Healthcare Solutions (Remote, Full-Time)GeBBS H... Show more

 • Promoted

Remote Job $790/wk - Hiring Focus Group Panelists

MaxionAltadena, CA, US
Remote
Full-time +2

Want to make extra money on YOUR schedule? Join our exclusive list of research study participants and .Perfect for anyone seeking remote, part-time, or temporary work, these opportunities require .... Show more

 • Promoted

17 Ways to Make Money From Home - Check out these Side Hustles and Gig Jobs Today

Remote Jobs For Youaltadena, ca, United States
Full-time

Side Hustles Flexible Work to Earn Extra Cash Looking to make extra money on the side? You dont need to leave your full-time job to do it.With flexible side hustles, you can earn on your own sche... Show more

 • Promoted

Senior Tax Expert Retail

IntuitMount Wilson, CA, United States
Full-time

Intuit is seeking highly motivated individuals to join our dynamic team as a dedicated Tax Expert - TurboTax Store in one of our new TurboTax locations across the United States on a seasonal basis.... Show more