Hcc Medical Coder

Role & Responsibilities

HCC Medical Coding Responsibilities

• Review patient medical records and provider documentation to accurately assign ICD-10-CM diagnoses for Risk Adjustment (HCC) coding.
• Ensure accurate capture of chronic and high-impact conditions supporting appropriate HCC and RAF score assignment.
• Validate clinical documentation to ensure compliance with CMS Risk Adjustment guidelines.
• Identify documentation gaps and recommend opportunities for improved condition capture.
• Collaborate with providers and internal teams to resolve coding-related issues efficiently.
• Perform chart reviews, coding validation, and quality audits.
• Maintain high coding accuracy, productivity, and compliance standards.
• Stay current with annual HCC model updates, coding guidelines, and regulatory changes.
• Demonstrate the ability to independently investigate, analyze, and resolve complex coding scenarios without operational delays.

Preferred Candidate Profile

Strong Knowledge of:

• ICD-10-CM Coding
• HCC (Hierarchical Condition Category) Coding
• CMS Risk Adjustment Methodology
• RAF Score Impact and Risk Adjustment Concepts
• Medical Terminology, Anatomy, and Disease Processes
• Coding and EMR Tools

Key Competencies:

• Strong analytical and critical thinking skills
• Ability to make sound coding decisions based on clinical documentation
• Smart, proactive, and solution-oriented approach to coding challenges
• Capability to independently resolve coding-related issues with minimal supervision
• Excellent attention to detail and commitment to quality
• Strong communication and collaboration skills

Eligibility Criteria

• Certification: CPC / CRC / CCS / COC (Preferred)
• Experience in HCC Coding / Risk Adjustment Coding
• Good understanding of CMS guidelines and compliance requirements

Preferred Candidates

Immediate Joiners.

Chennai residing candidates only.

Candidates with 6months to 1year experience can apply.

Candidates who can:

• Think strategically and make informed coding decisions
• Resolve coding discrepancies and documentation challenges effectively
• Take ownership of issues and drive resolutions without hiccups
• Contribute to process improvements and quality enhancement initiatives

Shift Timing:

3:00 PM to 12:00 AM IST(5:30 AM to 1:30PM EST).

"Drop will be provided for female candidates only".