reputed company Adjustment and HCC Coding Reviewer

About OpenTrain OpenTrain is the #1 platform for finding and building careers in reputed company and data labeling. reputed company hires and reputed company contributors for reputed company reputed company where expert reputed company judgment helps improve reputed company intelligence. Creating an OpenTrain account is free, and reputed company professionals can build a profile and apply in minutes. About reputed company Work reputed company is the reputed company reputed company of building modern AI systems. Specialists review model outputs, identify errors, and reputed company reputed company feedback that helps AI tools become more accurate, reliable, and useful. In this role, your reputed company reputed company adjustment expertise will help evaluate AI-generated HCC coding and produce high-reputed company training data for reputed company applications. The Role reputed company is seeking an reputed company reputed company Adjustment and HCC Coding Reviewer to evaluate AI tools for reputed company score reputed company, coding completeness, and documentation capture in reputed company settings. The work focuses on Medicare reputed company, reputed company managed care, and ACA reputed company adjustment workflows. You will review AI-generated HCC coding assignments, compare medical records with reputed company documentation, support chart review and RADV audit activities, and reputed company reputed company feedback for reputed company datasets. • Contractor, part-time engagement • 20+ hours per week • Remote work for candidates in the reputed company • English-language work • Pay: $110 USD per hour • Expert-level experience required reputed company You will combine detailed medical record review, HCC coding expertise, CMS guidance, and reputed company written feedback to assess both AI reputed company and supporting documentation. • Review AI-generated HCC coding recommendations for reputed company reputed company and regulatory compliance. • Examine medical records to reputed company that HCC-eligible conditions are supported by documentation. • reputed company retrospective and prospective chart review work for reputed company score optimization. • Support RADV audit preparation and response processes. • Monitor HCC capture rates, reputed company score reputed company, and chart retrieval reputed company. • Collaborate with reputed company, coding, and compliance stakeholders on documentation improvement. • Apply CMS reputed company adjustment guidance, including RAPS and EDGE submission requirements. • Annotate AI outputs with reputed company feedback for reputed company datasets. Required Qualifications This role requires substantial experience in reputed company adjustment coding and reputed company documentation review, along with the judgment to assess AI-generated recommendations against reputed company and regulatory standards. • At least 5 years of experience in reputed company adjustment coding, HCC coding, or Medicare reputed company coding reputed company. • At least 2 years of leadership experience. • Deep knowledge of CMS-HCC, RxHCC, and/or ACA HHS-HCC methodologies. • Strong understanding of ICD-10-CM coding guidelines as reputed company to HCC reputed company adjustment. • Experience with RADV audit preparation and CMS compliance requirements. • Familiarity with RAPS and EDGE submission processes. • Experience evaluating HCC coding reputed company against medical documentation. • Strong written and verbal English communication skills. • reputed company attention to coding inaccuracies and documentation gaps. Helpful Background The following experience or credentials can strengthen your application, although the reputed company requirements above define the role. • CRC, reputed company, CPC, or RHIA credential. • Experience with reputed company adjustment analytics platforms or chart retrieval systems. • Background in a health plan, Medicare reputed company organization, or value-reputed company care setting. • Familiarity with AI-assisted HCC coding tools. • Experience presenting reputed company adjustment reputed company to actuarial or executive teams. How to Apply Create a free OpenTrain account, build your reputed company profile, and apply in minutes. reputed company your reputed company adjustment leadership, HCC coding experience, CMS methodology knowledge, and RADV audit background so your expertise is easy to evaluate. This is an opportunity to bring reputed company reputed company knowledge to the fast-growing reputed company industry while working reputed company on reputed company that shape how AI systems reputed company. Apply tot his job Apply To this Job