HCC Coding Specialist

3 weeks ago

Hyderabad, Telangana, India Accessibility Planner Full time
Position: HCC Coding Specialist & Trainer

Location: [Appstruc solutions private ltd Hyderabad / Work from Office]

Employment Type: Full-time

About the Role

We are looking for an experienced HCC (Hierarchical Condition Category) Coding Specialist who is not only proficient in medical coding standards but is also passionate about training and mentoring new joiners. The role requires a blend of technical expertise, compliance knowledge, and strong communication skills to ensure both coding accuracy and knowledge transfer.

Key Responsibilities

- HCC Coding & Compliance
- Perform accurate HCC coding using ICD-10-CM guidelines in accordance with CMS regulations.
- Review medical records to ensure appropriate capture of diagnoses impacting risk adjustment.
- Conduct quality audits to ensure compliance with industry standards, payer requirements, and internal policies.
- Training & Mentorship
- Design and deliver structured training programs for new joiners in HCC coding.
- Prepare training materials, case studies, and coding scenarios to build strong foundational knowledge.
- Mentor, coach, and evaluate trainees' progress with constructive feedback.
- Provide refresher training sessions to keep the team updated on regulatory changes and best practices.
- Collaboration & Process Improvement
- Work closely with QA teams, auditors, and compliance teams to improve accuracy and efficiency.
- Identify gaps in trainee performance and implement improvement plans.
- Contribute to the development of standard operating procedures (SOPs) and training manuals.

Required Skills & Qualifications

- Bachelor's degree in Life Sciences, Healthcare, or related field (preferred).
- 3–6 years of experience in HCC coding with strong knowledge of ICD-10-CM guidelines.
- Certified Professional Coder (CPC), CRC, or equivalent certification is mandatory.
- Experience in training, mentoring, or leading junior coders is highly desirable.
- Strong analytical, communication, and presentation skills.
- Detail-oriented with the ability to work under minimal supervision.
- Knowledge of compliance, CMS regulations, and risk adjustment models.

Why Join Us?

- Opportunity to take on both technical coding and leadership/training responsibilities.
- Exposure to diverse case studies and continuous learning in compliance and risk adjustment.
- Be part of a supportive and growth-driven healthcare team.

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