Seeking experienced patient financial services leaders to evaluate healthcare AI systems, improve self-pay collections, optimize patient payment plans, enhance financial engagement, and maximize revenue recovery while maintaining compliance and patient satisfaction.
Risk Adjustment / HCC Coding Leader
United States
$110 – $110/hr
June 24, 2026
Job description
Role Overview
Mercor is partnering with a leading AI research laboratory to improve next-generation AI systems used in risk adjustment, value-based care, and healthcare coding operations.
The organization is seeking experienced Risk Adjustment and HCC Coding leaders to evaluate and improve AI tools designed to enhance risk score accuracy, coding completeness, documentation quality, and regulatory compliance across Medicare Advantage, Medicaid managed care, and ACA risk adjustment programs.
Responsibilities
Risk Adjustment Leadership
- Lead risk adjustment and HCC coding operations across Medicare Advantage, Medicaid Managed Care, and ACA Risk Adjustment Programs
- Support coding accuracy, documentation quality, and risk score optimization initiatives
Medical Record & Documentation Review
- Review medical records to ensure complete and accurate capture of HCC-supported diagnoses
- Identify documentation gaps affecting risk score accuracy
AI Evaluation & Quality Review
- Evaluate AI-generated HCC coding assignments, risk adjustment recommendations, and documentation improvement opportunities
- Assess outputs for coding accuracy, clinical validity, regulatory compliance, and documentation support
- Provide structured annotations and feedback for AI training datasets
Audit & Compliance Management
- Manage RADV (Risk Adjustment Data Validation) audit preparation and support audit response activities
Requirements
- 5+ years of experience in Risk Adjustment Coding, HCC Coding, or Medicare Advantage Coding Operations
- Minimum 2 years in a leadership role
- Deep knowledge of CMS-HCC methodology, RxHCC methodology, and ACA HHS-HCC methodology
- Strong knowledge of ICD-10-CM coding guidelines within risk adjustment environments
Preferred Qualifications
- CRC (Certified Risk Coder), CCS, CPC, or RHIA certification
- Experience with risk adjustment analytics platforms or Medicare Advantage organizations
Contract & Payment Terms
- Independent contractor engagement · Fully remote · Flexible schedule
- Weekly payments through Stripe or Wise
- US work authorization required · No visa sponsorship
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