Senior Medical Coder

1 week ago

Chennai, India Invent Health Full time

Job Title: Senior Medical Coder - Risk Adjustment Coding


·     The ideal candidate will be responsible for accurately coding and auditing medical records to ensure proper documentation and compliance with regulatory standards.

·     This role requires a deep understanding of coding guidelines and risk adjustment methodologies, along with the ability to mentor junior coders.


Key Responsibilities:

·      Perform comprehensive coding of medical records related to patient diagnoses and treatments while ensuring adherence to CMS guidelines for risk adjustment.

·      Review and audit clinical documentation to ensure accurate and complete coding, identifying areas for improvement and education.

·      Collaborate with healthcare providers to clarify and ensure accurate documentation of diagnosis codes.

·      Analyze and report on coder performance metrics and identify trends or discrepancies in coding practices.

·      Mentor and train junior coding staff in best practices, coding standards, and compliance regulations.

·      Stay updated on changes to coding guidelines, regulations, and risk adjustment methodologies (e.g., HCC coding).

·      Assist in the development and implementation of coding policies and procedures to enhance consistency and compliance.

·      Collaborate with interdisciplinary teams to support initiatives aimed at improving documentation and coding accuracy.

·      Participate in ongoing education and professional development to maintain and enhance coding credentials.


Qualifications and Skills:

·      Bachelor's degree – Life science, Nursing, or a related field preferred.

·      Certified Professional Coder (CPC), Certified Risk Adjustment Coder (CRC), or equivalent coding certification required.

·      Minimum of [2-6] years of experience in medical coding, with a focus on Risk Adjustment coding.

·      Strong knowledge of ICD-10-CM coding, CPT coding, and HCPCS coding systems.

·      Proven experience with coding audits and quality assurance processes.

·      Excellent analytical, critical thinking, and problem-solving skills.

·      Strong attention to detail and commitment to accuracy and compliance.

·      Exceptional communication and interpersonal skills, with the ability to collaborate effectively with clinical teams.

·      Proficiency in coding software and electronic health record (EHR) systems.

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