Senior Medical Coding

6 days ago

Guindy Tamil Nadu, India Invent Health Full time ₹ 12,00,000 - ₹ 36,00,000 per year

Job Description: Senior Medical Coding & RADV Audit Specialist

Location:
 [Remote]

Employment Type:
 Contractor

About the Role

We are seeking a highly experienced, client-facing 
Medical Coding Expert
 with deep expertise in 
RADV (Risk Adjustment Data Validation) audits
 across multiple clients and health plans. The ideal candidate is comfortable engaging directly with clients, has extensive hands-on experience across all lines of business (Medicare Advantage, Medicaid, and ACA), and is proficient in using 
coder workbench platforms
.

This is a senior role that requires both technical coding proficiency and the ability to provide strategic guidance and audit support to our clients.

Key Responsibilities

  • Lead and support 
    RADV audits
     across diverse client portfolios, ensuring compliance and accuracy in documentation.
  • Serve as a 
    trusted client-facing coding expert
    , communicating audit findings, clarifications, and recommendations.
  • Perform 
    medical chart reviews
     with accuracy and speed, ensuring proper HCC capture and alignment with CMS guidelines.
  • Leverage 
    coder workbench tools
     to streamline coding workflows and improve efficiency.
  • Work across 
    all lines of business (Medicare, Medicaid, ACA)
     with demonstrated adaptability to plan-specific requirements.
  • Collaborate with risk adjustment, quality, and analytics teams to ensure coding practices align with organizational and regulatory standards.
  • Stay current on 
    ICD-10-CM guidelines, HCC coding updates (V24–V28), CMS RADV protocols
    , and other compliance requirements.
  • Support internal teams and clients during 
    audit preparation, submission, and response processes
    .
  • Provide 
    training, mentoring, and guidance
     to junior coders as needed.

Required Qualifications

  • 5–7+ years
     of hands-on medical coding experience, with a strong focus on 
    risk adjustment and RADV audits
    .
  • Certified coder credentials (e.g., 
    CPC, CRC, CCS, CCS-P
    ) strongly preferred.
  • Proven client-facing experience with 
    multiple health plans or audit engagements
    .
  • Deep knowledge of 
    ICD-10-CM, HCC coding, and CMS risk adjustment guidelines
    .
  • Proficiency with 
    coder workbench systems and EHR platforms
    .
  • Demonstrated ability to code across 
    all LOBs (MA, Medicaid, ACA)
    .
  • Strong attention to detail, compliance mindset, and ability to meet deadlines under pressure.
  • Excellent communication and presentation skills for client interactions.

Preferred Skills

  • Experience leading 
    RADV audit defense and appeals
    .
  • Knowledge of 
    encounter data submission requirements
    .
  • Familiarity with 
    provider education and documentation improvement strategies
    .
  • Ability to work in a fast-paced, client-driven environment with minimal supervision.

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