Associate Ii

3 days ago

Thiruvananthapuram Kerala, India UST Global Full time

2 - 3 Years
- 2 Openings
- Kochi, Trivandrum

**Role description**:
The Certified MRA Coder I performs **retrospective reviews** of medical records to abstract **ICD-10-CM diagnosis codes** in alignment with **Risk Adjustment program** requirements. The goal is to accurately capture the health plan members’ burden of illness and support proper documentation for **Commercial, Medicare, and Medicaid** Risk Adjustment Programs.

**Primary Responsibilities**:

- Ensure compliance with all applicable federal laws and regulations related to coding and documentation for Risk Adjustment Programs.
- Conduct **remote medical record reviews** to identify and capture relevant diagnosis codes that fall under **Hierarchical Condition Categories (HCC)**.
- Perform **two-way reviews** by auditing claims data and removing unsupported ICD-10-CM codes.
- Validate that all diagnosis codes are fully supported by medical documentation and compliant with ICD-10-CM Official Guidelines and client-specific coding instructions.
- Maintain coding quality, accuracy, and productivity metrics as defined by the organization.

**Employment Qualifications**:
**Education & Certification (required)**:

- High school diploma or equivalent.
- Completion of a certified medical coding program.
Acceptable certifications include:

- CPC, COC, CRC (AAPC)
- CCS, CCS-P (AHIMA)
- CPC-A with required experience is acceptable.
- Active certification and continuing education/membership maintenance required.

**Experience**:

- Minimum **2 years of HCC risk adjustment coding experience**, or
- **1 year of general medical coding** experience with **2 years of clinical-related healthcare** experience.

**Skills, Knowledge & Abilities (SKA)**:

- In-depth understanding of **Risk Adjustment programs**, including coding and data validation requirements.
- Strong knowledge of **ICD-10-CM coding guidelines** and AHA Coding Clinic guidance.
- Advanced understanding of **medical terminology**, **pharmacology**, **anatomy/physiology**, and **disease pathology**.
- Ability to work efficiently across multiple **lines of business**, coding platforms, and EMR systems.
- Excellent **time management** and the ability to meet deadlines with mínimal supervision.
- Strong attention to detail with a high level of **accuracy**, **completeness**, and **production efficiency**.
- Clear and professional communication skills, both written and verbal.

**Skills**:
Risk Adjustments programs coding and data Validation,Medical Terminology,Pharmacology

**About UST**:
UST is a global digital transformation solutions provider. For more than 20 years, UST has worked side by side with the world’s best companies to make a real impact through transformation. Powered by technology, inspired by people and led by purpose, UST partners with their clients from design to operation. With deep domain expertise and a future-proof philosophy, UST embeds innovation and agility into their clients’ organizations. With over 30,000 employees in 30 countries, UST builds for boundless impact—touching billions of lives in the process.

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