Medical Coder (HCC)

Roles & Responsibilities:

-Validate and enhance clinical documentation to support accurate, complete, and compliant coding for Medicare beneficiaries under the CMS-HCC risk adjustment model.

-Perform detailed chart reviews and assign accurate ICD-10 diagnosis and procedure codes for risk adjustment purposes.

-Maintain productivity targets by coding an average of 30 charts per day.

Ensure medical documentation complies with all regulatory requirements and risk adjustment coding guidelines.

-Achieve and maintain a minimum coding accuracy rate of 95%.

-Stay current with ICD-10, CMS-HCC, and Risk Adjustment coding guidelines, regulations, and industry updates.

-Utilize multiple EHR systems efficiently to conduct comprehensive chart reviews and coding activities.

-Identify documentation gaps and opportunities for provider education to improve coding accuracy and risk capture.

-Support audit readiness by ensuring coding integrity and adherence to compliance standards.

Collaborate with internal teams to enhance coding quality, documentation practices, and operational efficiency.

Requirements:

- Strong proficiency in ICD-10-CM, CPT, and HCPCS coding systems, particularly in the context of risk adjustment.

- Thorough understanding of medical coding procedures and compliance requirements.

- Excellent communication skills for effective collaboration and clear, concise reporting.

- Demonstrated ability to manage time effectively and meet productivity standards.

- High level of integrity and professionalism in handling confidential information.