Department: Coding & Clinical Documentation
Experience Required: 4+ years in risk adjustment coding
Employment Type: Full time

Role SummaryWe are looking for an experienced Risk Adjustment Coding SME to serve as a go-to expert for our coding team in Chennai. You will review and code medical records with a high degree of accuracy, guide coders on complex cases, support quality and audit activities, and help maintain compliance with CMS-HCC, HHS-HCC, and other risk adjustment guidelines.
Work Model• Hybrid: a combination of in-office days at our Chennai location and remote work, as per team schedule and business needs.
• Reliable high-speed internet and a secure home workspace are required for remote days, in line with HIPAA and data security policies.
• Shift timings may be aligned with US business hours, depending on project requirements.
Key Responsibilities• Review medical records (inpatient, outpatient, physician, and specialist documentation) and assign accurate ICD-10-CM codes for risk adjustment programs (Medicare Advantage, ACA, Medicaid).




• Ensure coding supports HCC capture in line with official coding guidelines, CMS requirements, and payer-specific rules.
• Serve as the primary resource for coders on complex or ambiguous coding scenarios and documentation queries.
• Conduct quality audits, including second-level reviews and RADV-readiness reviews, and provide constructive feedback to coders.
• Identify documentation gaps and coding trends, and recommend corrective actions or provider education.
• Train and mentor new and existing coders, and conduct refresher sessions on guideline and regulatory updates.
• Contribute to developing and updating coding policies, SOPs, job aids, and training material.
• Meet or exceed productivity and accuracy benchmarks (typically 95%+ accuracy).
• Collaborate with clinical, compliance, quality, and operations teams to resolve coding-related issues.
• Stay current with annual ICD-10-CM updates, CMS model changes, and indus

📌 Subject Matter Expert (Chennai)
🏢 Invent Health
📍 Chennai