15 Aug
|
Agilys Nxt
|
India
Job Title: HCC Medical Coder (Risk Adjustment) – Hyderabad Experience: 1–3 years
We are seeking a detail-oriented HCC Medical Coder with 1–3 years of hands-on experience in risk adjustment coding to join our growing team in Hyderabad. In this role, you will review clinical documentation, assign accurate ICD-10-CM codes, and ensure strict adherence to HCC guidelines, HIPAA, and payer-specific compliance standards for Medicare Advantage, ACA, and commercial risk adjustment programs.
This is a high-impact role where your coding accuracy directly influences quality scores, risk adjustment factors (RAF), and reimbursement integrity.
Medical Record Review: Analyze inpatient, outpatient, and professional fee charts to assign accurate ICD-10-CM diagnosis codes that reflect chronic conditions and comorbidities.
HCC / Risk Adjustment Coding: Identify and code Hierarchical Condition Categories (HCCs) ensuring documentation meets M.Compliance & Quality Assurance: Maintain 95%+ coding accuracy while meeting daily/weekly productivity targets.
Participate in internal audits and support RADV (Risk Adjustment Data Validation) readiness.
Clinical Documentation Improvement (CDI): Collaborate with providers, team leads, and CDI specialists to clarify documentation gaps and ensure diagnoses are supported, specific, and actionable.
Reporting & Tools: Use encoder software (e.g., Prepare coding reports and track quality metrics using Excel or internal dashboards.
Continuous Learning: Stay updated on ICD-10-CM Official Guidelines, AHA Coding Clinic, and CMS/HHS risk adjustment model updates.
Experience: 1–3 years of production coding experience in HCC / Risk Adjustment (Medicare Advantage, ACA, Medicaid, or Commercial).
Coding Proficiency: Robust command of ICD-10-CM, medical terminology, anatomy, physiology, and pathophysiology.
Certifications (Required/Preferred): Active AAPC or AHIMA certification such as CRC, CPC, CCS, or CCS-P. CRC certification is strongly preferred or must
📌 HCC Medical Coder (India)
🏢 Agilys Nxt
📍 India