Risk-Adjustment / HCC Coding Leader

The Convergence of Healthcare Operations and Frontier Artificial Intelligence

The healthcare industry is experiencing a profound technological transformation, moving beyond basic electronic health records into sophisticated artificial intelligence and predictive modeling. Within this paradigm shift, risk adjustment and Hierarchical Condition Category (HCC) coding remain some of the most critical operational pillars for Medicare Advantage, Medicaid managed care, and Affordable Care Act (ACA) market programs. Ensuring absolute accuracy, compliance, and clinical completeness in risk score calculations directly dictates the quality of patient care management and financial viability for healthcare organizations.

However, next-generation AI systems cannot independently master the complex nuances of CMS guidelines, clinical documentation validation, and RADV audit defense without elite human oversight. Platforms like Mercor are bridging this gap by partnering with leading AI research labs to connect seasoned healthcare operations leaders with high-impact remote consulting contracts. The Risk-Adjustment / HCC Coding Leader position represents a premier opportunity for senior medical coding professionals to monetize their specialized expertise at an impressive rate of $110 per hour.

Detailed Job Overview & Responsibilities

For certified coders, health plan directors, and value-based care executives seeking high-yield independent work, understanding the exact scope of this role is crucial. The position requires senior-level professional judgment to audit, evaluate, and refine AI-driven tools designed to optimize risk score accuracy and coding completeness.

Key Responsibilities:

• Operational Leadership: Lead and guide risk adjustment and HCC coding operations across complex Medicare Advantage, Medicaid, and ACA risk adjustment programs.
• AI Output Evaluation: Evaluate AI-generated HCC coding assignments and risk score recommendations for strict clinical accuracy, documentation backing, and regulatory compliance.
• Medical Record Review: Review intricate medical records to ensure complete, accurate capture of HCC-eligible conditions fully supported by clinical documentation.
• Audit Readiness: Conduct and oversee retrospective and prospective chart reviews, alongside managing Risk Adjustment Data Validation (RADV) audit preparation and response workflows.
• KPI Monitoring: Track and monitor essential risk adjustment metrics, including HCC capture rates, risk score precision, and overall chart retrieval efficiency.
• Cross-Functional Collaboration: Partner closely with clinical, coding, and compliance teams to continually enhance documentation standards for risk adjustment purposes.
• Regulatory Adherence: Ensure absolute compliance with official CMS risk adjustment guidelines, including RAPS and EDGE submissions.
• Dataset Annotation: Annotate cutting-edge AI outputs and deliver structured coding feedback to train and scale robust healthcare AI training datasets.

Candidate Requirements: What It Takes to Qualify

Because these roles involve shaping mission-critical AI applications for leading enterprise healthcare environments, the qualification criteria are designed to attract senior industry authorities.

Contract Terms, Flexibility, and Global Payment Infrastructure

Independent contracting through Mercor provides elite professionals with complete professional autonomy while ensuring fair, prompt compensation for their time:

• Independent Contractor Engagement: Complete your evaluation milestones flexibly on your own schedule from any remote location within the United States.
• Dynamic Project Adaptability: Projects scale dynamically based on enterprise research demands, offering flexibility to manage your workload around existing commitments.
• Streamlined Weekly Payouts: Earnings are disbursed weekly via dependable financial platforms like Stripe and Wise, providing complete transparency and rapid turnaround.

Why This Role Maximizes Your Professional Value

Years spent navigating complex medical records, managing RADV audits, and optimizing risk pools represent a rare, highly specialized skillset. Traditional healthcare management structures often tie professionals down to burdensome administrative overhead and office politics. In contrast, AI training and evaluation consulting allows you to focus purely on high-level analysis and clinical strategy.

Working alongside world-class AI research organizations also positions you at the absolute forefront of healthcare technology innovation. You gain early visibility into the tools that will define value-based care and risk adjustment workflows for decades to come—all while earning an exceptional $110 per hour.

Take the Next Step in Your Healthcare Career

High-paying independent contract roles with elite compensation and flexible schedules fill up fast as demand for specialized healthcare AI training surges. If you possess the required leadership background in HCC coding and risk adjustment, now is the ideal time to secure your position.