10 Aug
|
Curitics Health
|
Noida
10 Aug
Curitics Health
Noida
Job Summary
We are seeking an experienced medical coding and risk adjustment leader to manage and strengthen our coding, quality, compliance, and clinical documentation improvement functions.
The role will oversee end-to-end medical coding operations across HCC risk adjustment, inpatient and outpatient coding, emergency department, evaluation and management, ambulatory surgery center, and other multispecialty coding programs.
The selected professional will be responsible for improving coding accuracy, documentation quality, revenue integrity, operational performance, and regulatory compliance. The role will also involve team leadership, client engagement, process transitions, quality governance, performance analytics, and implementation of technology-enabled coding solutions.
This position is suitable for a senior healthcare skilled who can combine medical coding expertise with operational leadership, quality improvement, client management, and digital transformation.
Key Responsibilities
Medical Coding and Risk Adjustment
Lead end-to-end medical coding operations for provider and payer programs.
Oversee HCC risk adjustment coding for Medicare Advantage and other health plan programs.
Ensure accurate capture of HCCs, chronic conditions, disease specificity, complications, comorbidities, and patient acuity.
Review RAF-related coding outcomes and support reimbursement and revenue-integrity objectives.
Provide coding oversight across inpatient, outpatient, emergency department, E/M, ASC, surgery, and multispecialty coding.
Ensure correct application of ICD-10-CM, CPT, HCPCS, ICD-10-PCS, MS-DRG, and APR-DRG guidelines.
Support CDI initiatives for physician and hospital coding programs.
Identify documentation gaps, unsupported diagnoses, coding discrepancies, and improvement opportunities.
Quality and Compliance
Establish and manage coding-quality, audit, and compliance frameworks.
Conduct or oversee coding audits, HCC reviews and documentation-quality assessments.
📌 Lead HCC Risk Adjustment Medical Coder (Noida)
🏢 Curitics Health
📍 Noida