Website:
agilysnxt.com
Job details:
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
- 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
How to Apply
Interested candidates can apply directly on LinkedIn or send their resume to talent@agilysnxt.com 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.
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