Team Lead HCC Medical Coding Risk Adjustment

Job TitleTeam Lead HCC Medical Coding / Risk Adjustment

Location: Hyderabad
Industry: US Healthcare / Medical Coding / RCM

Department: Operations / Medical Coding

Job Summary We are looking for an experienced HCC Medical Coding Team Lead to manage and guide a team of HCC / Risk Adjustment Medical Coders.The candidate will be responsible for team performance, coding quality, productivity, TAT, SLA adherence, training, and day-to-day operations. The role requires strong knowledge of HCC Coding, Risk Adjustment, ICD-10-CM, CMS guidelines, and Medicare Advantage.

Roles & Responsibilities

• Lead and manage a team of HCC / Risk Adjustment Medical Coders.
• Ensure accurate coding as per HCC, ICD-10-CM, CMS, and Risk Adjustment guidelines.
• Monitor team productivity, quality, accuracy, TAT, and SLA performance.
• Review coding errors and provide regular feedback and coaching to team members.
• Handle complex coding queries and provide appropriate guidance to coders.
• Conduct regular quality checks and coding audits.
• Identify performance gaps and implement corrective action plans.
• Conduct training, refresher sessions, and knowledge-sharing sessions for the team.
• Manage daily work allocation and ensure timely completion of assigned volumes.
• Prepare and track daily/weekly/monthly MIS and performance reports.
• Ensure compliance with client requirements, process guidelines, and company policies.
• Support internal and client audits and ensure timely closure of audit observations.
• Coordinate with Quality, Training, Audit, and Operations teams.
• Identify process gaps and drive continuous improvement initiatives.
• Support new-hire training, nesting, and onboarding activities.
• Monitor individual and team performance and conduct regular performance discussions.
• Escalate operational issues and risks to the reporting manager in a timely manner.
• Maintain good communication with internal stakeholders and support client requirements.

Required Skills

• Strong knowledge of HCC Coding and Risk Adjustment.
• Good understanding of ICD-10-CM coding guidelines.
• Knowledge of CMS Risk Adjustment and Medicare Advantage.
• Experience in HCC chart review / medical record review.
• Strong knowledge of coding quality and audit processes.
• Good understanding of productivity, TAT, SLA, and quality metrics.
• Excellent team-handling and people-management skills.
• Strong analytical and problem-solving skills.
• Good communication and presentation skills.
• Experience in preparing and analyzing MIS / performance reports.
• Ability to handle escalations and resolve coding-related issues.
• Good knowledge of MS Excel and reporting tools.

Experience

• 5-7 years of experience in US Healthcare / Medical Coding.
• Prior experience as Team Lead / SME / Senior Medical Coder preferred.
• Experience managing a team of 10-25+ coders is preferred.
• Candidates with experience in Medicare Advantage / HCC Coding / Risk Adjustment will be preferred.

Qualification

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

Preferred Candidate Profile

Looking for candidates with strong experience in HCC Medical Coding / Risk Adjustment, who have demonstrated experience in team handling, coding quality, productivity management, training, and operational delivery.

Key Skills

HCC Coding | Risk Adjustment | Medical Coding | ICD-10-CM | CMS | Medicare Advantage | HCC | Chart Review | Coding Audit | Coding Quality | Team Lead | SME | Team Handling | Productivity | TAT | SLA | US Healthcare | RCM

Interested candidates can share their updated resume to:

[email protected]