Risk-adjustment / HCC coding leader

$110/hrrate as listed

Review AI-generated HCC assignments and risk adjustment recommendations against clinical documentation and CMS guidelines, then write structured feedback that trains the model. Mercor lists this contract at an observed $110/hr, remote and asynchronous, for coders with 5+ years in risk adjustment and at least 2 in a leadership seat.

Summary, eligibility guidance and screening preparation are prepared by Sidequest from the platform's posting. Check the source listing before applying.

What the work actually looks like

You receive medical record excerpts paired with model output — an HCC assignment, a suspected-condition flag, a query recommendation, or a narrative summary of risk-relevant findings. Your job is to decide whether the documentation supports the code under MEAT/TAMPER-style scrutiny, whether the ICD-10-CM selection and hierarchy logic are correct, and whether the output would survive a RADV review. When it fails, you write a rationale precise enough that a non-coder annotator could apply the same standard to the next case.

Expect a mix of task types: binary accept/reject with justification, side-by-side preference ranking between two model responses, rubric scoring across accuracy and compliance dimensions, and occasional authoring of gold-standard exemplars. Some batches focus on a single methodology — CMS-HCC v28, RxHCC, or HHS-HCC — and calibration to that model's coefficients and payment year matters.

What the screen measures

Verifiable depth. Expect follow-ups on hierarchy trumping, coefficient changes between v24 and v28, and the documentation standard for a condition you claim to have coded routinely.
Judgment under ambiguity. Many cases sit in the gap between technically codeable and audit-defensible; the platform wants to see how you reason there, not whether you have a memorized rule.
Written clarity. Feedback that says "unsupported" without citing the missing documentation element does not train anything.
Compliance posture. Reviewers who optimize purely for capture rate tend to screen out.

Logistics

Fully remote and asynchronous. Most contributors take 10–20 hours per week against a batch deadline rather than fixed shifts, and volume fluctuates with lab demand — steady stretches followed by quiet weeks are normal. Pay is stated as observed on the platform and varies by task complexity and calibration performance; treat $110/hr as a reference point, not a guarantee. Onboarding typically includes a paid or unpaid calibration set that determines whether you continue.

What they look for

5+ years in risk adjustment / HCC coding, with 2+ years leading a team or program
Deep working knowledge of CMS-HCC (v24/v28), RxHCC, or HHS-HCC methodology
ICD-10-CM coding guidelines as applied to risk adjustment documentation standards
RADV audit preparation and CMS compliance experience
CRC, CCS, CPC, or RHIA credential (strongly preferred)
Clear written English capable of explaining a coding decision to a non-coder

Before you apply

Would you pass this screen?

Drawn from what this listing actually requires. Answered in your browser — nothing is sent to us, and we do not store your answers.

Do you have 5 or more years of professional experience in risk adjustment coding, HCC coding, or Medicare Advantage coding operations?
Years of risk adjustment or HCC coding experience · required
Have you held a leadership role (supervisory, operational lead, or higher) in risk adjustment, HCC coding, or related Medicare Advantage operations for at least 2 years?
Leadership experience in this domain · required
Do you hold a current, active CRC (Certified Risk Coder), CCS (Certified Coding Specialist), CPC (Certified Professional Coder), or RHIA (Registered Health Information Administrator) credential?
Medical coding credential · preferred
Have you directly participated in RADV (Risk Adjustment Data Validation) audit preparation or response activities?
RADV audit exposure · preferred
Are you able to communicate verbally and in writing in English at a professional level, including clear explanation of technical risk adjustment concepts?
Fluent English communication · required

0 of 5 answered

Included with this listing

Interview prep — 11 questions

Matched to what this platform's screening actually measures. Answer each out loud in 60–90 seconds: claim → concrete example → implication.

What it tests: Whether they can isolate a concrete HCC coding mistake (not just 'improved documentation'), trace its impact on risk adjustment KPIs or audit liability, and show pattern-level thinking that transfers to evaluating AI output.
A strong answer: They name a real HCC that was missed or miscoded, explain the clinical documentation that should have supported it, state the dollar or member-level impact (e.g., 'removed $2M of unsubstantiated risk'), and describe what process gap or provider behaviour led to it—not just 'I found it and fixed it.'
Where people lose it: Describing process improvements in the abstract ('we implemented a better review workflow') without naming a specific condition, ICD-10 code, or measurable impact; or conflating documentation capture with accurate HCC assignment.