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Seasonal Optum Health Coding Risk Adjustment Jobs in New York

Mercor

HCC Coding Leader - Risk Adjustment

New York, NY · Remote

$110/hr

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

Stanford Health Care

Sr Risk Adjustment Coder

Newark, NJ

$44.13 - $57.36/hr

... healthcare setting with demonstrated knowledge and of regulatory billing and coding guidelines ... CRC - Certified Risk Adjustment Coder * CCDS - Cert Clinical Document Spec preferred Physical ...

MetroPlusHealth

Risk Adjustment Specialist

Manhattan, NY · On-site

$72K - $82K/yr

Position Overview Risk Adjustment is a growing and critical field within Health Insurance Finance. This is your opportunity to support this function at MetroPlusHealth, New York City's not-for-profit ...

MetroPlusHealth

Risk Adjustment Specialist

Manhattan, NY · Hybrid

$72K - $82K/yr

Position Overview Risk Adjustment is a growing and critical field within Health Insurance Finance. This is your opportunity to support this function at MetroPlusHealth, New York City's not-for-profit ...

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All JobsOptum Health Coding Risk Adjustment JobsSeasonal Optum Health Coding Risk Adjustment JobsSeasonal Optum Health Coding Risk Adjustment Jobs in New York

Seasonal Optum Health Coding Risk Adjustment information

What is a Seasonal Optum Health Coding Risk Adjustment?

A Seasonal Optum Health Coding Risk Adjustment position involves reviewing medical records and coding diagnoses for risk adjustment purposes, typically during peak times of the year. These professionals help ensure that patient health conditions are accurately documented and coded according to regulatory guidelines. This role supports healthcare organizations in receiving proper reimbursement and maintaining compliance. Seasonal positions are usually temporary, aligning with periods of increased workload, such as annual data submissions.

What are the key skills and qualifications needed to thrive as a Seasonal Optum Health Coding Risk Adjustment?

To excel as a Seasonal Optum Health Coding Risk Adjustment Specialist, you need expertise in medical coding (preferably with a CPC, CRC, or CCS certification), a solid understanding of ICD-10 guidelines, and knowledge of risk adjustment methodologies. Familiarity with electronic health record (EHR) systems, coding software, and Optum's proprietary platforms is typically required. Attention to detail, analytical thinking, and effective communication are essential soft skills for accurately interpreting clinical documentation and collaborating with healthcare teams. These competencies are crucial to ensure precise coding, regulatory compliance, and optimal reimbursement for healthcare organizations.

What are some common challenges faced by Seasonal Optum Health Coding Risk Adjustment professionals, and how can they be managed?

Seasonal Optum Health Coding Risk Adjustment professionals often encounter challenges such as handling high volumes of medical records within tight deadlines and ensuring coding accuracy to meet regulatory standards. Staying up-to-date with frequent coding guideline changes and adapting quickly to new technologies or platforms are also common hurdles. To manage these challenges, it's helpful to establish efficient workflows, participate in ongoing training, and maintain open communication with team members and supervisors for clarification or support.

What is the difference between Seasonal Optum Health Coding Risk Adjustment vs Medical Coder?

AspectSeasonal Optum Health Coding Risk AdjustmentMedical Coder
CertificationsCPHQ, CPC, or CCS often preferredCPC, CCS, or equivalent certifications
Work EnvironmentHealthcare insurance, risk adjustment teams, remote or office-basedHospitals, clinics, or insurance companies, often office-based
Job FocusAnalyzing and coding health data for risk adjustment, seasonal workload peaksAssigning medical codes to patient records for billing and documentation

Seasonal Optum Health Coding Risk Adjustment specialists focus on analyzing health data for risk adjustment, often during peak seasons, requiring specific certifications. Medical Coders primarily assign codes to medical records for billing, working in various healthcare settings. While both roles involve medical coding, their focus, environment, and seasonal demands differ significantly.

What are the most commonly searched types of Optum Health Coding Risk Adjustment jobs in New York?

The most popular types of Optum Health Coding Risk Adjustment jobs in New York are:

What are popular job titles related to Seasonal Optum Health Coding Risk Adjustment jobs in New York?

For Seasonal Optum Health Coding Risk Adjustment jobs in New York, the most frequently searched job titles are:

What job categories do people searching Seasonal Optum Health Coding Risk Adjustment jobs in New York look for?

The top searched job categories for Seasonal Optum Health Coding Risk Adjustment jobs in New York are:

What cities in New York are hiring for Seasonal Optum Health Coding Risk Adjustment jobs?

Cities in New York with the most Seasonal Optum Health Coding Risk Adjustment job openings:

Seasonal Optum Health Coding Risk Adjustment jobs near you
Infographic showing various Seasonal Optum Health Coding Risk Adjustment job openings in New York as of August 2026, with employment types broken down into 72% Full Time, and 28% Contract. Highlights an 66% In-person, and 34% Remote job distribution.

HCC Coding Leader - Risk Adjustment

Mercor

New York, NY • Remote

$110/hr

Full-time

Re-posted 25 days ago

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 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.

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.