Job Title : HCC Medical Coder (Risk Adjustment Coder)
Department: Medical Coding / Revenue Cycle Management (RCM)
Location : Hyderabad
Job Summary
We are seeking a detail-oriented and experienced HCC Medical Coder to review medical records and accurately assign ICD-10-CM diagnosis codes in accordance with CMS-HCC Risk Adjustment guidelines. The ideal candidate will ensure accurate Hierarchical Condition Category (HCC) capture, maintain coding compliance, and contribute to improved quality reporting and reimbursement.
Key Responsibilities
Review patient medical records, physician documentation, and clinical notes.
Assign accurate ICD-10-CM diagnosis codes based on current coding guidelines.
Identify and capture Hierarchical Condition Categories (HCCs) for Medicare Risk Adjustment.
Ensure documentation supports all assigned diagnosis codes.
Follow CMS Risk Adjustment, Official ICD-10-CM Coding Guidelines, and client-specific coding policies.
Query providers for clarification when documentation is incomplete or ambiguous.
Maintain coding quality and productivity targets established by the organization.
Participate in internal and external coding audits.
Stay updated with annual ICD-10-CM, CMS-HCC, and regulatory changes.
Maintain HIPAA compliance and patient confidentiality.
Collaborate with Quality Assurance, Clinical Documentation Improvement (CDI), and Operations teams to improve coding accuracy.
Required Qualifications
Bachelor's degree in Life Sciences, Pharmacy, Nursing, Allied Health, or related healthcare discipline.
CPC, CRC, CCS, or equivalent coding certification preferred.
2+ years of HCC/Risk Adjustment coding experience
Robust knowledge of ICD-10-CM coding guidelines.
Positive understanding of Medicare Risk Adjustment and CMS-HCC models.
Familiarity with medical terminology, anatomy, physiology, and disease processes.