Job Summary

We are looking for an experienced and results-driven Assistant Manager HCC Coding to oversee HCC/Risk Adjustment coding operations, drive operational excellence, ensure coding accuracy and regulatory compliance, and achieve business performance targets. The role will be responsible for managing team leads and coding teams, monitoring productivity and quality, strengthening process controls, and ensuring adherence to CMS, ICD-10-CM, risk-adjustment, and client-specific coding guidelines.

The ideal candidate should have strong expertise in HCC coding, people management, operational planning, quality governance, performance improvement, and stakeholder management.

Key Responsibilities

1. Operations and Team Management

- Manage day-to-day HCC/Risk Adjustment coding operations to meet productivity, quality, accuracy, and turnaround time targets.
- Lead and guide team leads, SMEs, senior coders, and coding teams to achieve operational goals.
- Ensure optimal resource utilization, capacity planning, workload distribution, and adherence to staffing requirements.
- Monitor daily, weekly, and monthly operational performance against defined SLAs and KPIs.
- Drive accountability, employee engagement, performance management, and continuous improvement across the team.
- Support recruitment, onboarding, nesting, and workforce development initiatives in coordination with relevant departments.

2. Coding Quality and Compliance

- Ensure accurate and compliant HCC coding based on medical record documentation and applicable coding guidelines.
- Oversee quality audits, coding validation, and compliance monitoring to identify gaps and recurring errors.
- Ensure adherence to CMS guidelines, ICD-10-CM coding standards, risk-adjustment models, and client-specific requirements.
- Review critical coding escalations and complex medical-record scenarios, providing appropriate guidance and resolution.
- Drive corrective and preventive action plans to address quality issues and reduce recurring errors.
- Ensure appropriate clinical documentation support for coded diagnoses and maintain compliance with applicable audit requirements.

3. Performance Monitoring and Reporting

- Track and analyze operational metrics,



including productivity, quality, accuracy, turnaround time, attendance, and utilization.
- Prepare and review performance dashboards, MIS reports, and management updates.
- Analyze trends, identify performance gaps, and implement action plans to achieve business targets.
- Conduct periodic performance reviews with team leads and individual contributors.
- Present operational performance, key risks, improvement opportunities, and action plans to senior management.

4. People Development and Capability Building

- Develop team leads and SMEs through structured coaching, mentoring, and performance reviews.
- Ensure regular refresher training, coding updates, and knowledge-sharing sessions.
- Collaborate with the training and quality teams to address knowledge gaps and improve coding competency.
- Drive employee development, succession planning, and initiatives to improve team capability and retention.
- Support performance improvement plans for employees not meeting established productivity or quality standards.

5. Process Improvement and Operational Excellence

- Identify process inefficiencies, operational bottlenecks, and opportunities to improve productivity and quality.
- Implement standard operating procedures, process controls, and best practices across coding operations.
- Drive continuous improvement initiatives to enhance accuracy, reduce rework, and improve turnaround time.
- Participate in internal and external calibration sessions to ensure consistent interpretation of coding guidelines.
- Support the implementation of new coding processes, technology enhancements, and operational changes.

6. Stakeholder and Client Management

- Coordinate with QA, training, operations, compliance, workforce management, and client-facing teams.
- Participate in client calls, business reviews, calibration meetings,



and operational governance discussions as required.
- Address client escalations, audit observations, and operational concerns within agreed timelines.
- Ensure timely communication of coding updates, process changes, risks, and performance trends.
- Build strong working relationships with internal and external stakeholders to support business objectives.

7. Regulatory and Industry Updates

- Stay updated on annual ICD-10-CM changes, CMS guidance, HCC model updates, and risk-adjustment regulatory requirements.
- Ensure timely communication and implementation of relevant coding updates across the team.
- Assess the operational impact of regulatory and coding changes and coordinate necessary training and process updates.

Required Skills and Qualifications

- Bachelor's degree in Life Sciences, Healthcare, Nursing, or a related field preferred.
- 510 years of relevant experience in HCC/Risk Adjustment coding or healthcare coding operations.
- Minimum 13 years of experience in a leadership or management role, preferably managing team leads, SMEs, or large coding teams.
- Strong knowledge of ICD-10-CM, HCC coding principles, risk adjustment, and medical record review.
- Valuable understanding of CMS guidelines, clinical documentation requirements, and applicable compliance standards.
- Proven experience managing operational KPIs, SLAs, productivity, quality, and turnaround time.
- Demonstrated ability to lead teams, develop team leads, manage performance, and drive accountability.
- Strong analytical, problem-solving, decision-making, and process improvement skills.
- Experience in quality governance, audit management, root cause analysis, and corrective action planning.
- Proficiency in MS Excel, reporting tools, dashboards, and performance analysis.
- Excellent communication, stakeholder management, and presentation skills.
- Ability to manage multiple priorities and deliver results in a deadline-driven environment.

Preferred Certifications

- AAPC CRC (Certified Risk Adjustment Coder).
- AAPC CPC (Certified Professional Coder).
- AHIMA CCS/CCS-P or an equivalent medical coding certification.

📌 Assistant Manager HCC Coding (Indore)
🏢 Access Healthcare
📍 Indore