Senior / Experienced HCC Medical Coder & QA

Novelite Rcm; Hyderabad; On-site; INR 450,000 - 600,000; Full time

Job summary

Novelite Rcm in Hyderabad seeks Senior/HCC Medical Coders and Quality Analysts with 1-4 years of US Healthcare Risk Adjustment experience to join the team. You will code using ICD-10-CM, capture HCCs, and adhere to CMS guidelines while maintaining accuracy.

The role involves QA tasks, audits, and continuous improvement to ensure compliance and high-quality coding, with emphasis on productivity, quality metrics, and timely turnaround.

Qualifications

• 1–4 years of experience in HCC / Risk Adjustment Medical Coding.
• Good knowledge of ICD-10-CM and HCC Coding.
• Understanding of CMS Risk Adjustment and Medicare Advantage.
• Good knowledge of medical terminology and anatomy.
• Experience in HCC coding, coding audit, or quality review.
• Strong attention to detail and analytical skills.
• Ability to meet productivity, quality, and TAT targets.
• Good communication and problem-solving skills.
• CPC / CCS / CRC certification is preferred.

Responsibilities

• Review medical records and accurately assign ICD-10-CM codes.
• Identify and capture appropriate HCCs based on clinical documentation.
• Perform coding as per CMS Risk Adjustment and HCC guidelines.
• Ensure complete and accurate documentation of supported diagnoses.
• Meet daily productivity, quality, and TAT targets.
• Follow client-specific coding guidelines and requirements.
• Identify documentation gaps and escalate complex cases when required.
• Participate in training, feedback, and calibration sessions.
• Maintain compliance with CMS, HIPAA, and company guidelines.
• Perform quality audits of HCC / Risk Adjustment coding charts.
• Review coding accuracy and HCC capture based on documentation.
• Identify coding errors and provide feedback to coders.
• Ensure compliance with CMS Risk Adjustment guidelines.
• Conduct root cause analysis for recurring coding errors.
• Monitor quality scores and coding accuracy.
• Participate in calibration and quality improvement sessions.
• Support internal and client audits.
• Prepare quality reports and maintain audit documentation.
• Coach coders to improve coding quality and accuracy.

Skills

HCC Coding

Risk Adjustment

Medical Coding

ICD-10-CM

CMS guidelines

CPC / CCS / CRC

Job description

Job Title: Senior / Experienced HCC Medical Coder & Quality Analyst Location: Hyderabad Domain: US Healthcare | HCC / Risk Adjustment Experience: 1-4 Years

Job Summary

We are hiring HCC Medical Coders and Quality Analysts with 1-4 years of experience in US Healthcare Risk Adjustment / HCC Coding.

The candidate should have good knowledge of ICD-10-CM, HCC Coding, Risk Adjustment, Medicare Advantage, and CMS guidelines and should be able to maintain high standards of coding accuracy and quality.

Key Responsibilities HCC Medical Coder

• Review medical records and accurately assign ICD-10-CM codes.
• Identify and capture appropriate HCCs based on clinical documentation.
• Perform coding as per CMS Risk Adjustment and HCC guidelines.
• Ensure complete and accurate documentation of supported diagnoses.
• Meet daily productivity, quality, and TAT targets.
• Follow client-specific coding guidelines and requirements.
• Identify documentation gaps and escalation complex cases when required.
• Participate in training, feedback, and calibration sessions.
• Maintain compliance with CMS, HIPAA, and company guidelines.

Key Responsibilities – QA

• Perform quality audits of HCC / Risk Adjustment coding charts.
• Review coding accuracy and HCC capture based on documentation.
• Identify coding errors and provide feedback to coders.
• Ensure compliance with CMS Risk Adjustment guidelines.
• Conduct root cause analysis for recurring coding errors.
• Monitor quality scores and coding accuracy.
• Participate in calibration and quality improvement sessions.
• Support internal and client audits.
• Prepare quality reports and maintain audit documentation.
• Coach coders to improve coding quality and accuracy.

Required Skills

• 1–4 years of experience in HCC / Risk Adjustment Medical Coding.
• Good knowledge of ICD-10-CM and HCC Coding.
• Understanding of CMS Risk Adjustment and Medicare Advantage.
• Good knowledge of medical terminology and anatomy.
• Experience in HCC coding, coding audit, or quality review.li>
• Strong attention to detail and analytical skills.
• Ability to meet productivity, quality, and TAT targets.
• Good communication and problem-solving skills.
• CPC / CCS / CRC certification is preferred.

Key Skills:

HCC Coding | Risk Adjustment | HCC Medical Coding | Medical Coding | ICD-10-CM | CMS Risk Adjustment | Medicare Advantage | HCC Coding QA | Coding Quality | Coding Audit | US Healthcare

Candidate Profile

We are looking for:

• Senior HCC Medical Coders
• Experienced HCC Medical Coders
• HCC Quality Analysts
• HCC Coding QA
• Risk Adjustment Medical Coders
• HCC Coding Auditors