HCC Medical Coder - 1-3 Years Experience

Job Title: HCC Medical Coder (Risk Adjustment) – Hyderabad

Experience: 1–3 years

Work Model: On-site

Location: Hyderabad, India

About the Role

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.

Key Responsibilities

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.E.A.T. (Monitor, Evaluate, Assess, Treat) criteria and payer-specific requirements.

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., 3M, TruCode) and EHR platforms (e.g., Epic, Cerner) to code efficiently. 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.

Qualifications & Requirements

Experience: 1–3 years of production coding experience in HCC / Risk Adjustment (Medicare Advantage, ACA, Medicaid, or Commercial).

Coding Proficiency: Strong 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 be obtained within 90 days of joining.

Technical Skills: Familiarity with encoder tools, EHR systems, and Microsoft Excel (pivot tables, VLOOKUP).

Attributes: Sharp analytical skills, exceptional attention to detail, ability to work independently, and a strong commitment to compliance and quality.

Education: High School Diploma required; Associate's or Bachelor's degree in Health Information Management, Life Sciences, or related field is a plus.

What We Offer

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• Competitive salary with performance-based incentives
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• Comprehensive training on HCC models, RADV audits, and payer guidelines
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• Career growth path into senior coder, auditor, or CDI specialist roles
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• Collaborative, compliance-first culture with regular upskilling opportunities
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How to Apply

Interested candidates can apply directly on LinkedIn or send their resume to [email protected] with the subject line: "HCC Coder Application – LinkedIn".

Agilys Nxt is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.