Risk Adjustment Coding Jobs

Risk adjustment coding jobs are a specialized healthcare entity: professional ICD-10-CM/HCC coders and auditors who review clinical documentation to optimize risk scores for Medicare Advantage and ACA plans. On Rex.zone, these roles connect directly to real-world AI/ML training workflows: data labeling of diagnoses, named entity recognition in clinical notes, QA evaluation, prompt evaluation for LLM-assisted coding, and RLHF to refine medical coding assistants. The page targets informational, transactional, and navigational intent—explaining the work, inviting candidates to apply, and anchoring discovery to Rex.zone—while covering modifiers like remote, contract, freelance, full-time, entry-level, and senior across NLP, computer vision, content safety, and LLM training domains.

Job Image

About the Role

Risk adjustment coders assign ICD-10-CM codes, map conditions to HCCs, validate documentation, and ensure accurate RAF calculations. Responsibilities include chart review, diagnosis capture from problem lists and provider notes, encounter data reconciliation, RADV audit readiness, and compliance with payer policies. Roles span coder, auditor, QA lead, and clinical documentation integrity specialist, supporting health plans, provider groups, AI labs, and annotation vendors.

AI/ML-Integrated Workflows

You will contribute to training data quality for medical AI: annotation guidelines compliance, labeled datasets for named entity recognition, model performance improvement, large language model evaluation, and prompt evaluation for coding assistants. Work may include computer vision annotation for scanned charts, content safety labeling and PHI redaction, and RLHF to improve coder-in-the-loop systems within LLM training pipelines.

Key Responsibilities

Perform prospective and retrospective chart review; capture hierarchical conditions; validate chronicity, specificity, and M.E.A.T. criteria; query providers; reconcile claims and encounters; support RADV audits; document coding decisions; follow policies and coding guidelines; maintain HIPAA privacy; partner with data ops to label clinical entities; provide QA evaluation feedback; contribute to annotation guidelines and test sets.

Required Skills

Expertise in ICD-10-CM and HCC models (MA and ACA); strong clinical documentation review; familiarity with EHRs (Epic, Cerner) and coding tools; understanding of payer rules, risk models, RAF trends, and audit processes; high attention to detail; English fluency; HIPAA compliance. Credentials such as CRC, CPC, CCS, or CCDS preferred. Bonus: experience with NLP labeling platforms, basic SQL/Python for data review, and LLM-assisted coding workflows.

Employment Types & Search Modifiers

Openings include remote, hybrid, and on-site; contract, freelance, and full-time; entry-level, mid, and senior. Domain focus spans NLP for clinical notes, computer vision for document images, content safety for PHI controls, and LLM training in healthcare. Employers include AI labs, tech startups, BPOs, annotation vendors, health plans, and provider organizations.

Impact & Outcomes

Your work drives accurate risk scores, revenue integrity, and population health insights. In AI pipelines, precise labeling improves training data quality, model performance improvement, and safe deployment of coding assistants. High-fidelity annotations enable named entity recognition and robust validators, reducing audit exposure and enhancing care quality.

Career Growth

Advance from coder to auditor, QA lead, documentation specialist, or AI data operations roles. Opportunities include guideline authorship, annotation program management, model evaluation lead, and clinical NLP product roles. Exposure to RLHF and LLM evaluation builds cross-functional skills at the intersection of healthcare coding and machine learning.

Compensation & Benefits

Competitive pay aligned to credentials and experience, with rates for contract and freelance projects and salary bands for full-time roles. Benefits vary by employer and may include healthcare, PTO, education support, and flexible schedules. Senior auditors and QA leads may receive premiums for RADV readiness, guideline development, and team leadership.

How to Apply on Rex.zone

Explore openings, filter by remote or on-site, and submit a profile highlighting certifications and HCC experience. Showcase examples of annotation guidelines compliance, QA evaluation results, and LLM prompt evaluation. Apply directly on Rex.zone to be matched with AI labs, health plans, and vendors supporting risk adjustment coding initiatives.

Frequently Asked Questions

  • Q: What is risk adjustment coding?

    It is the assignment of ICD-10-CM codes that map to HCC categories to calculate risk scores for Medicare Advantage and ACA plans, ensuring documentation supports the specificity and chronicity required for accurate RAF.

  • Q: Which certifications are preferred?

    CRC, CPC, CCS, and CCDS are commonly requested. Auditing roles may prefer additional credentials or documented RADV experience.

  • Q: How does the role interface with AI/ML?

    Coders contribute labeled diagnoses, validate named entities in clinical text, perform QA evaluation, and participate in prompt evaluation and RLHF to improve LLM-assisted coding tools and validators.

  • Q: Is remote work available?

    Yes. Roles include remote, hybrid, and on-site, with options for contract, freelance, and full-time employment across entry-level to senior levels.

  • Q: What tools will I use?

    EHR systems, coding platforms, audit and validation tools, secure labeling environments for NLP and computer vision, and LLM-assisted coding applications. HIPAA-compliant workflows and content safety controls are standard.

  • Q: What employers post on Rex.zone?

    AI labs, tech startups, BPOs, annotation vendors, health plans, and provider organizations seeking coders, auditors, and QA leads for risk adjustment projects.

  • Q: How do I apply on Rex.zone?

    Create a profile, upload credentials, highlight HCC and audit experience, and apply to roles. The platform matches you with opportunities and supports screening and interview scheduling.

  • Q: Are entry-level candidates considered?

    Yes, for junior coding and labeling roles with mentorship and training. Senior roles require demonstrated audit readiness, guideline authorship, or team leadership.

230+Domains Covered
120K+PhD, Specialist, Experts Onboarded
50+Countries Represented

Industry-Leading Compensation

We believe exceptional intelligence deserves exceptional pay. Our platform consistently offers rates above the industry average, rewarding experts for their true value and real impact on frontier AI. Here, your expertise isn't just appreciated—it's properly compensated.

Work Remotely, Work Freely

No office. No commute. No constraints. Our fully remote workflow gives experts complete flexibility to work at their own pace, from any country, any time zone. You focus on meaningful tasks—we handle the rest.

Respect at the Core of Everything

AI trainers are the heart of our company. We treat every expert with trust, humanity, and genuine appreciation. From personalized support to transparent communication, we build long-term relationships rooted in respect and care.

Ready to Shape the Future of Medical Coding?

Apply Now.