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Full Time Remote Risk Adjustment Coder Jobs in Tennessee

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 ...

Senior Outpatient Coder

Brentwood, TN · Remote

$17.75 - $23.75/hr

Senior Outpatient Coder Position Details: Full-Time Remote Reports to Coding Operations Manager You ... Supports Quality, Risk Management, Case Management, and other departments regarding HIM and coding ...

Senior Outpatient Coder

Brentwood, TN · Remote

$17.75 - $23.75/hr

Senior Outpatient Coder Position Details: Full-Time Remote Reports to Coding Operations Manager You ... Supports Quality, Risk Management, Case Management, and other departments regarding HIM and coding ...

Senior Outpatient Coder

Brentwood, TN · Remote

$17.75 - $23.75/hr

Senior Outpatient Coder Position Details: Full-Time Remote Reports to Coding Operations Manager You ... Supports Quality, Risk Management, Case Management, and other departments regarding HIM and coding ...

Senior Outpatient Coder

Brentwood, TN · Remote

$17.75 - $23.75/hr

Senior Outpatient Coder Position Details: Full-Time Remote Reports to Coding Operations Manager You ... Supports Quality, Risk Management, Case Management, and other departments regarding HIM and coding ...

$200K - $250K/yr

Remote: Experity offers Team Members the opportunity to work remotely or in an office. Team members ... Develop appropriate controls that reduce risk while enabling efficient operations. * Ensure ...

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Showing results 1-20

Full Time Remote Risk Adjustment Coder information

What is the difference between Full Time Remote Risk Adjustment Coder vs Full Time Remote Medical Coder?

AspectFull Time Remote Risk Adjustment CoderFull Time Remote Medical Coder
CertificationsRHIT, RHIA, CCS, CPCCPC, CCS, RHIT
Work EnvironmentRemote, healthcare insurance companies, risk adjustment teamsRemote, hospitals, clinics, healthcare facilities
Industry UsageHealth insurance, risk adjustment programsHospitals, clinics, healthcare providers
Job FocusAnalyzing diagnoses for risk scores, coding for risk adjustmentMedical record coding, billing, and documentation

The main difference is that Full Time Remote Risk Adjustment Coders focus on analyzing diagnoses to support risk scores for insurance reimbursement, often requiring specific certifications like RHIT or CCS. Full Time Remote Medical Coders handle general medical coding for billing and documentation, with certifications like CPC or CCS. Both roles are remote but serve different purposes within the healthcare industry.

What are the most commonly searched types of Remote Risk Adjustment Coder jobs in Tennessee?

The most popular types of Remote Risk Adjustment Coder jobs in Tennessee are:

What are popular job titles related to Full Time Remote Risk Adjustment Coder jobs in Tennessee?

For Full Time Remote Risk Adjustment Coder jobs in Tennessee, the most frequently searched job titles are:

What job categories do people searching Full Time Remote Risk Adjustment Coder jobs in Tennessee look for?

The top searched job categories for Full Time Remote Risk Adjustment Coder jobs in Tennessee are:

What cities in Tennessee are hiring for Full Time Remote Risk Adjustment Coder jobs?

Cities in Tennessee with the most Full Time Remote Risk Adjustment Coder job openings:

Risk Adjustment Expert - AI Trainer

Mercor

Nashville, TN • Remote

$110/hr

Full-time

This job post has expired 1 day ago. Applications are no longer accepted.


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: https://talent.docs.mercor.com/welcome
  • For any help or support, reach out to: support@mercor.com

PS: Our team reviews applications daily. Please complete your AI interview and application steps to be considered for this opportunity.


#hiringmercor