HCC Medical Coder - 1-3 Years Experience

Agilys Nxt; Hyderabad; On-site; INR 350,000 - 750,000; Full time

Benefits offered by this job

Competitive salary and incentives

Comprehensive training on HCC models

Career growth into senior coder or CDI

Upskilling opportunities

Job summary

Agilys Nxt in Hyderabad seeks a detail-oriented HCC Medical Coder with 1-3 years of hands-on risk adjustment coding experience. You will review clinical documentation, assign ICD-10-CM codes, and ensure compliance with MEAT criteria and payer guidelines for Medicare Advantage and ACA.

This role impacts RAF, quality scores, and reimbursement integrity. You will work with encoder tools and EHRs, collaborating with CDI teams to close documentation gaps and maintain coding accuracy.

Qualifications

• 1–3 years of production coding experience in HCC / Risk Adjustment (Medicare Advantage, ACA, Medicaid, or Commercial).
• Strong command of ICD-10-CM, medical terminology, anatomy, physiology, and pathophysiology.
• Active AAPC or AHIMA certification such as CRC, CPC, CCS, or CCS-P (CRC preferred or within 90 days).

Responsibilities

• Review clinical documentation to assign accurate ICD-10-CM codes reflecting chronic conditions and comorbidities.
• Identify and code HCCs ensuring documentation meets MEAT criteria and payer requirements.
• Maintain 95%+ coding accuracy while meeting daily/weekly productivity targets and support RADV readiness.
• Collaborate with providers and CDI specialists to close documentation gaps.
• Use encoder software and EHR platforms to code efficiently; prepare coding reports and track quality metrics.
• Stay updated on ICD-10-CM guidelines and CMS risk adjustment model updates.

Skills

Attention to detail

Analytical thinking

Compliance awareness

Independent work

Education

High School Diploma

Associate's or Bachelor's in Health Information Management

Tools

3M Encoder

TruCode

Epic

Cerner

Excel

Job description

Experience: 1-3 years

Work Model: On-site

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

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

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