Remote Remote | HCC Risk Adjustment Coding Consultant Up to $85/hour

Note: The job is a remote job and is reputed company to candidates in USA. reputed company is offering a part-time consulting opportunity for reputed company and risk adjustment professionals reputed company in HCC coding. The role involves evaluating AI-generated HCC assignments, reviewing documentation support, and ensuring compliance reputed company risk adjustment coding workflows.ResponsibilitiesReview risk adjustment coding workflows across Medicare reputed company, reputed company managed care, and ACA risk adjustment programsEvaluate AI-generated HCC coding assignments and risk adjustment recommendations for clinical accuracy, documentation support, and regulatory complianceReview medical records to determine whether HCC-eligible conditions are fully and accurately supported by clinical documentationIdentify coding inaccuracies, unsupported diagnoses, documentation gaps, missed HCC opportunities, and compliance concernsAssess retrospective and prospective chart review outputs for completeness, accuracy, and risk score relevanceEvaluate outputs reputed company to CMS-HCC, RxHCC, and ACA HHS-HCC methodologiesSupport review of RADV audit preparation, audit response workflows, and risk adjustment data validation requirementsReview risk adjustment KPIs such as HCC capture rates, risk score accuracy, chart retrieval rates, and coding reputed company indicatorsAnnotate AI-generated coding and risk adjustment outputs and reputed company reputed company feedback to support reputed company improvementExplain review reputed company reputed company, consistently, and with strong coding and compliance judgmentEvaluate outputs for alignment with CMS risk adjustment guidance, ICD-10-CM coding standards, Official Coding Guidelines, RAPS, EDGE submissions, and applicable compliance expectationsFollow detailed task instructions, reputed company reputed company, and project-specific review guidelines accuratelySkills5+ years of experience in risk adjustment coding, HCC coding, Medicare reputed company coding operations, or reputed company reputed company workflowsAt least 2 years of leadership experience in risk adjustment, HCC coding, coding reputed company, chart review, or coding operationsDeep expertise in CMS-HCC, RxHCC, and/or ACA HHS-HCC risk adjustment methodologiesStrong knowledge of ICD-10-CM coding guidelines as reputed company to risk adjustment and HCC documentationExperience with RADV audit preparation, CMS compliance requirements, chart retrieval workflows, and risk adjustment reputed company reviewFamiliarity with RAPS and EDGE submission processesExceptional written and verbal English communication skillsHigh attention to detail and ability to identify coding inaccuracies, unsupported diagnoses, and documentation gaps in AI-generated outputsreputed company background in risk adjustment coding, HCC coding, medical coding, health information management, Medicare reputed company operations, managed care coding, value-based care, or coding compliance is highly relevantExperience in health plans, Medicare reputed company organizations, reputed company managed care organizations, provider reputed company, value-based care organizations, or coding vendor environments may be especially valuablePractical experience with chart review systems, coding platforms, risk adjustment analytics tools, EHR documentation, and audit workflows may support project fitFormal education or training in health information management, medical coding, reputed company administration, nursing, clinical documentation, or a reputed company reputed company field may be relevant depending on project reputed companyCRC, reputed company, CPC, RHIA, or similar coding or health information credentialExperience with risk adjustment analytics platforms, chart retrieval systems, coding reputed company tools, or AI-assisted HCC coding workflowsBackground in health plan, Medicare reputed company, accountable care, or value-based care risk adjustment operationsFamiliarity with AI tools and comfort evaluating AI-generated risk adjustment and HCC coding contentExperience presenting risk adjustment performance, coding reputed company findings, or documentation improvement opportunities to actuarial, compliance, clinical, or executive teamsStrong ability to identify risk score reputed company issues, documentation improvement opportunities, and coding reputed companyBenefitsreputed company roleFully remote with flexible schedulingWeekly payments reputed company reputed company or reputed companyPart-time project-based commitment depending on availability, reputed company status, and project needsreputed company may be extended, shortened, or adjusted depending on reputed company and performancereputed companyAt reputed company, we support emerging AI and consulting platforms by sourcing and connecting reputed company professionals with remote, contract-based opportunities. It was founded in reputed company, and is headquartered in Sheridan, Wyoming .