CRC / CPC Medical Coder

18 hours ago

Gandhinagar, Gujarat, India Skillra Technologies Full time

Key Responsibilities

  • Review clinical documentation (patient medical records) and assign appropriate diagnosis and procedure codes using ICD‑10‑CM, CPT (and HCPCS if applicable) guidelines.
  • Conduct Risk Adjustment / HCC (Hierarchical Condition Category) coding: identify and code chronic conditions accurately.
  • Perform chart audits to evaluate documentation insufficiencies and ensure they support code assignments.
  • Ensure that coded data adhere to payer / regulatory guidelines and internal compliance standards.
  • Resolve queries with providers or documentation authors when medical records are unclear or missing needed details.
  • Maintain productivity and accuracy targets as set by the team / project (for example, % accuracy, turnaround time).
  • Stay updated with coding changes, industry regulations, payer policies (e.g. CMS, Medicare Advantage etc.), and coding certification requirements.
  • Participate in ongoing training and process improvement initiatives.
  • (If applicable) Assist in denial management, claims adjudication, revenue leakage identification, and support payment integrity.
  • Maintain confidentiality and security of patient data (HIPAA / applicable local laws).

Required Qualification

  • Certification: CPC (Certified Professional Coder) and/or CRC (Certified Risk Adjustment Coder) from recognized bodies (e.g. AAPC).
  • Educational Qualification: Graduate (Bachelor's degree) preferably in Life Sciences (e.g. B.Sc, B.Pharma, Biotechnology, Microbiology, Nursing etc.).
  • Experience: Typically 1‑3 years coding experience in U.S. healthcare / risk adjustment / HCC / multispecialty coding. For senior roles maybe more.
  • Strong knowledge of medical terminology, anatomy & physiology.
  • Proficiency with ICD‑10‑CM, CPT, HCPCS (if needed), and other coding systems.
  • Good analytical skills, attention to detail, ability to work under deadlines.
  • Communication skills: both written and verbal (for interacting with providers, auditors, etc.).
  • Computer skills: comfortable using EHR / EMR tools, basic MS Office (Excel, Word), coding / auditing software.
  • Experience with payer policies, Medicare Advantage, Medicaid, RADV audits.
  • Prior experience in facility setting (inpatient / outpatient) coding, or surgery / pathology etc specialties.
  • Ability to mentor / train junior coders.
  • Familiarity with coding compliance, appeals / denials handling.

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