HCC & Risk Adjustment Leader for AI-Driven Coding

Obsidian; New York (NY); On-site; USD 90,000 - 120,000; Full time

Benefits offered by this job

Collaborate with a world-class AI research organization

Exposure to cutting-edge AI workflows

Job summary

Obsidian is seeking experienced leaders in Risk Adjustment and HCC Coding to work with a leading AI research lab focused on improving AI systems for Medicare Advantage and ACA markets. The role involves evaluating AI tool outputs and ensuring coding and compliance accuracy.

The ideal candidate will have over 5 years in risk adjustment coding along with expertise in CMS methodologies. They will manage coding operations and collaborate with clinical teams to enhance risk score integrity while contributing to innovative AI projects in healthcare.

Qualifications

• 5+ years of experience in risk adjustment coding or Medicare Advantage coding operations.
• Deep expertise in CMS-HCC, RxHCC, and/or ACA HHS-HCC methodologies.
• Exceptional written and verbal English communication skills.

Responsibilities

• Lead risk adjustment and HCC coding operations across various programs.
• Evaluate AI-generated coding assignments for accuracy.
• Manage audit preparation and response processes.

Skills

Risk adjustment coding

HCC coding

Medicare Advantage coding operations

ICD-10-CM coding guidelines

RADV audit preparation

Attention to detail

Education

CRC, CCS, CPC, or RHIA credential

Tools

Risk adjustment analytics platforms

Chart retrieval systems

Job description

Obsidian is seeking experienced leaders in Risk Adjustment and HCC Coding to work with a leading AI research lab focused on improving AI systems for Medicare Advantage and ACA markets. The role involves evaluating AI tool outputs and ensuring coding and compliance accuracy.

The ideal candidate will have over 5 years in risk adjustment coding along with expertise in CMS methodologies. They will manage coding operations and collaborate with clinical teams to enhance risk score integrity while contributing to innovative AI projects in healthcare.