Assistant Manager HCC Medical Coding Risk Adjustment

Job Title : Assistant Manager HCC Medical Coding / Risk Adjustment

We are looking for an experienced Assistant Manager HCC Medical Coding / Risk Adjustment to lead and manage HCC coding operations while overseeing multiple teams of HCC / Risk Adjustment Medical Coders.

The candidate will be responsible for driving operational excellence, ensuring coding quality, productivity, client satisfaction, SLA adherence, people management, process improvements, and compliance with CMS Risk Adjustment guidelines. The role requires strong expertise in HCC Coding, Risk Adjustment, ICD-10-CM, CMS guidelines, Medicare Advantage, and operations management.

Roles & Responsibilities

• Manage end-to-end HCC / Risk Adjustment Medical Coding operations across multiple teams.
• Lead, mentor, and develop Team Leads, SMEs, and HCC Medical Coders to achieve operational goals.
• Ensure accurate coding in accordance with HCC, ICD-10-CM, CMS, Risk Adjustment, and Medicare Advantage guidelines.
• Drive team performance by monitoring productivity, quality, accuracy, TAT, SLA, and utilization metrics.
• Review operational dashboards and implement action plans to achieve business KPIs.
• Oversee coding quality audits, identify trends, and implement preventive and corrective actions.
• Collaborate with Quality, Training, Audit, and Operations teams to improve coding accuracy and compliance.
• Handle client escalations, operational issues, and complex coding-related queries.
• Ensure adherence to client requirements, regulatory guidelines, HIPAA compliance, and internal quality standards.
• Conduct regular governance meetings, performance reviews, and operational reviews with internal stakeholders and clients.
• Develop and implement process improvement initiatives to enhance productivity, quality, and operational efficiency.
• Analyze productivity, quality, and financial metrics and prepare daily, weekly, and monthly MIS reports.
• Support resource planning, capacity planning, workforce allocation, and forecasting activities.
• Drive employee engagement, retention, succession planning, and performance management initiatives.
• Support recruitment, interviewing, onboarding, and development of new team members.
• Ensure successful completion of internal, external, and client audits.
• Identify operational risks and proactively implement mitigation plans.
• Foster a culture of continuous learning, accountability, and operational excellence.

Required Skills

• Strong expertise in HCC Coding and Risk Adjustment.
• Excellent knowledge of ICD-10-CM coding guidelines.
• Strong understanding of CMS Risk Adjustment and Medicare Advantage.
• Experience in HCC chart review, medical record review, and coding audits.
• Strong knowledge of coding quality, compliance, and audit methodologies.
• Proven experience managing productivity, quality, TAT, SLA, and operational KPIs.
• Excellent leadership, stakeholder management, and people management skills.
• Strong analytical, problem-solving, and decision-making abilities.
• Experience in client communication and operational governance.
• Proficiency in MS Excel, reporting tools, and MIS preparation.
• Ability to manage escalations, drive process improvements, and deliver operational excellence.

Experience

• 810 years of experience in US Healthcare / Medical Coding.
• Minimum 3**–5 years of experience in Team Lead, Assistant Manager, or Operations Management roles**.
• Experience managing multiple teams or 30–100+ coders is preferred.
• Strong experience in Medicare Advantage, HCC Coding, Risk Adjustment, Quality, and Operations Management.

Qualification

• Any Graduate / Post Graduate.
• CPC / CRC / CCS / CIC certification is preferred.
• Relevant medical coding certification with strong HCC/Risk Adjustment experience will be an added advantage.

Preferred Candidate Profile

Looking for candidates with strong expertise in HCC Medical Coding / Risk Adjustment Operations, who have demonstrated success in managing large teams, driving coding quality, improving productivity, ensuring compliance, handling client relationships, and delivering operational excellence in a US Healthcare environment.

Key Skills

HCC Coding | Risk Adjustment | Medical Coding | ICD-10-CM | CMS | Medicare Advantage | HCC | Chart Review | Coding Audit | Coding Quality | Operations Management | Assistant Manager | Team Management | People Management | Productivity | Quality | TAT | SLA | Client Management | MIS Reporting | US Healthcare | RCM

Interested candidates can share their updated resume to:

[email protected]