Risk Adjustment Expert - AI Trainer
$110 per hourMercor
Job Description
Job Description
About the job
Mercor connects elite creative and technical talent with leading AI research labs. Headquartered in San Francisco, our investors include Benchmark , General Catalyst , Peter Thiel , Adam D'Angelo , Larry Summers , and Jack Dorsey .
Position: Risk-adjustment / HCC coding leader
Type: Contract
Compensation: $110/hour
Location: Remote
Role Responsibilities
- Lead risk adjustment and HCC coding operations across Medicare Advantage , Medicaid , and 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 optimization.
- Manage RADV audit preparation and response processes.
- Collaborate with clinical, coding, and compliance teams to improve documentation and coding for risk adjustment purposes.
Qualifications
Must-Have
- 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
- 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 organization, 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.
Application Process (Takes 20–30 mins to complete)
- Upload resume
- AI interview based on your resume
- Submit form
Resources & Support
- For details about the interview process and platform information, please check:
- For any help or support, reach out to: View email address on ziprecruiter.com
PS: Our team reviews applications daily. Please complete your AI interview and application steps to be considered for this opportunity.
#hiringmercorVacancy posted 12 days ago
Similar jobs that could be interesting for youBased on the Risk Adjustment Expert - AI Trainer in Nashville, TN vacancy
- 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...Risk
- Mercor is partnering with a leading AI research lab to build risk adjustment capabilities across Medicare Advantage, Medicaid, and ACA markets. We seek experienced Risk Adjustment and HCC Coding leaders to guide AI tool evaluation and ensure documentation capture and coding...Risk
$156.7k - $244.9k
...transformations. As an Asset Management Professional - Expert based out of Tennessee, you’ll have the... ...Client relationship skills in performing risk analysis, audits and development of... ...require further support or reasonable adjustments with regards to the recruitment process (...RiskFull timeRemote work- ...expanding its Medicare strategy and insights team to support provider enablement. This role will act as a subject matter expert on Medicare Risk Adjustment, tracking activities and performance at provider group and sponsor levels. You will collaborate with RIPOE to create...Risk
- ...Entry Level Workers' Compensation Claims Adjuster Johnston & Associates is a family‑owned safety and risk management consulting company located in Thompsons Station, TN. We have been in business for over 35 years and continued to grow. We offer excellent benefits, including...RiskFull timeLocal areaFlexible hours
Johnston & Associates
Nashville, TN2 days ago $143.62k - $229.79k
...Job Description As a Consulting Actuary -ACA Risk Adjustment, you will play a pivotal role in delivering a wide array of actuarial and analytical services for our organization. Responsibilities include leading pricing strategies and actuarial initiatives for business segments...RiskBlue Cross and Blue Shield of North Carolina
Nashville, TN21 hours ago- Blue Cross NC is seeking a Consulting Actuary - ACA Risk Adjustment to lead pricing strategies and actuarial initiatives across business segments, evaluate advanced care management models, and design and price sophisticated insurance products. The role requires strong leadership...Risk
- ...Ncontracts leads the industry in integrated risk management and compliance solutions,... ...Ncontracts, you'll join a team of industry experts dedicated to strengthening the financial services... ...banking world. This person will join our AI Operations Group, led by our Director of...RiskFull timeTemporary workPart timeFor contractorsInternshipLocal areaFlexible hoursShift work
- ...company expertise. Our Crop Division has been helping farmers manage risk since 1915 and is one of the few private companies authorized by... ...part‑time. Hours fluctuate based on seasonal needs. As a Crop Adjuster, You Will Understand and work claims for all major crops,...RiskFull timePart timeSeasonal work
- ...become more resilient. Underpinned by technology, data, analytics, AI, change management, talent and sustainability capabilities, our... ...AI-enabled supply chain control towers for real-time visibility, risk sensing, and proactive disruption management.Collaborate with clients...RiskFull timeLive inWork at officeLocal area
$80 - $150 per hour
...creative and technical talent with leading AI research labs. Headquartered in San... ...of AI-generated conversations and provide expert judgment to calibrate automated evaluation... ...Preferred Experience conducting suicide risk assessments or crisis intervention. Academic...RiskContract workTraineeshipSummer workRemote workMercor
Nashville, TN4 days ago- ...Practice. HDR is a hydropower and dam safety industry leader. We are expert FERC Part 12 Dam Safety Program practitioners, and we are at the... ...mentorship of staff as needed or if required. Participate in risk assessments for dams and hydraulic structures.Some travel is...RiskContract workWork at officeFlexible hours
- A global fintech leader is seeking a Stop Loss Underwriter to evaluate and manage risk for employer-sponsored self-funded health plans. This role involves underwriting new business and renewals, ensuring profitability while working closely with various teams to deliver...Risk
- Hiverecruiter is seeking a Personal Lines Underwriter in Tennessee to evaluate and underwrite new business and policy changes for Homeowners risks. You will review inspections, reports, and renewals to ensure accurate risk selection and policy classification. Collaborate with...Risk
- A leading auditing firm in Nashville is seeking an experienced auditor to lead internal audit workstreams. The ideal candidate will have over 6 years of experience in auditing, knowledge of GAGAS standards, and strong analytical skills. Exceptional communication abilities...Risk
STI
Nashville, TN2 days ago - ...monitoring, tenant file reviews, and corrective action follow-up across MDHA properties. The role reports to the Director of Compliance and Risk Management and collaborates with the Senior Compliance Manager to ensure audit readiness and regulatory compliance. Responsibilities...Risk
$90 - $130 per hour
...Mercor connects elite creative and technical talent with leading AI research labs. Headquartered in San Francisco, our investors... ...Angelo , Larry Summers , and Jack Dorsey . Position: Domain Expert – Diagnostic Imaging (Visage 7 Research) Type: Contract Compensation...Contract workSummer workRemote work- ...organizational transformations. As an Asset Management Professional - Expert based out of Tennessee, you’ll have the opportunity to develop... ...change management. Client relationship skills in performing risk analysis, audits and development of corrective action plans....Risk
- Mercor is partnering with a leading AI research lab to advance risk adjustment processes for Medicare Advantage, Medicaid managed care, and ACA markets. We seek experienced leaders to drive HCC coding, risk score accuracy, and documentation capture across programs. You...Risk
- ...requiring multi-state expertise and experience managing a remote ER team. The position emphasizes strategic leadership, policy development, risk mitigation, and complex investigations, with a focus on employment law compliance across all 50 states. #J-18808-Ljbffr Akumin®RiskRemote job
$80 - $120 per hour
...Job Description Job Description About the job Mercor connects elite creative and technical talent with leading AI research labs. Headquartered in San Francisco, our investors include Benchmark , General Catalyst , Peter Thiel , Adam D'Angelo , Larry Summers...Contract workSummer workWork at officeRemote work$105.4k - $207.8k
...in improving the cyber and organizational risk profiles of leading companies? Do you want... ...foundations that power the next generation of AI-enabled cyber defense?If yes, then... ...The disclosed range estimate has not been adjusted for the applicable geographic differential...RiskLocal areaVisa sponsorship$75 - $120 per hour
...Job Description Job Description About the job Mercor connects elite creative and technical talent with leading AI research labs. Headquartered in San Francisco, our investors include Benchmark , General Catalyst , Peter Thiel , Adam D'Angelo , Larry Summers...Contract workSummer workRemote work$80 - $120 per hour
...Job Description Job Description About the job Mercor connects elite creative and technical talent with leading AI research labs. Headquartered in San Francisco, our investors include Benchmark , General Catalyst , Peter Thiel , Adam D'Angelo , Larry Summers...Contract workSummer workWork at officeRemote work$110.7k - $372.9k
...they need. Deloitte has a new AI-first effort, backed by $1B in... ...engineer with clinical and domain experts and teach you the domain — you... ..., latency, cost, and model risk. • Partner with our modeling... ...range is $110,700-$372,900 (not adjusted for geographic differential);...RiskLocal areaVisa sponsorship- ...expertise, and global footprint to offer commercial insurance solutions that address your business’s unique risks. Summary/Job Purpose This position is responsible to adjust assigned claims within delegated limits of authority, conduct timely and thorough investigations,...RiskLocal area
MSIG USA
Nashville, TN1 day ago $122k - $240.5k
Position Summary Agentic AI is moving from experimentation to production, and organizations... ...resource plans for your workstream, and adjust them as engagement needs evolveMonitor... ...'s change management processIdentify risks, assumptions, and constraints early, and implement...RiskWork at officeLocal areaVisa sponsorshipShift work$105.4k - $207.8k
...operating model improvements to strengthen security posture and reduce risk. A successful candidate would possess these skills: Ability to... ...organizational needs. The disclosed range estimate has not been adjusted for the applicable geographic differential associated with the...RiskLocal areaVisa sponsorship$93k - $171.3k
...role ends on 7/25/2026. Work you'll do As a Specialist Manager, Risk Compliance on the Personal Consultation team, you will be... ...organizational needs. The disclosed range estimate has not been adjusted for the applicable geographic differential associated with the location...RiskWork at officeVisa sponsorship$151.4k - $311k
...Summary Director, Applied AI Engineering Role Overview: As... ...the enterprise ecosystem.Expert Proficiency and Continuous Improvement... ...of innovation.Tech/Quality Risk Management: Establish and... ...disclosed range estimate has not been adjusted for the applicable geographic...RiskWork at officeLocal areaVisa sponsorship3 days per week
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Risk Adjustment Expert - AI Trainer. Be the first to apply!
Related searches