Concurrent Risk Adjustment Coder (CCS/CRC)

The client is a US HealthCare service provider and is looking to hire a Concurrent Risk Adjustment Coder (CCS/CRC) for their team at Hyderabad.

Department / Function:

Risk Adjustment | Coding Operations | Provider Documentation Support

Job Summary:

CCS or CRC-certified coder

Key Responsibilities:

• Perform

  post-visit (concurrent) chart reviews

  to ensure accurate and complete diagnosis capture for each encounter.
• Assign

  all applicable ICD-10-CM diagnosis codes

  for the visit, based on provider documentation and coding guidelines.
• Execute

  HCC capture and validation

  , ensuring diagnoses meet risk adjustment requirements and are supported by documentation.
• Verify diagnosis specificity and clinical support (e.g., status, acuity, laterality, complications, linkage).
• Identify documentation gaps that impact coding accuracy and communicate findings per workflow (query/escalation if applicable).
• Utilize

  EHR workflows

  effectively to review encounter notes, problem lists, assessments/plans, orders, labs, imaging, and historical records as needed.
• Maintain required

  productivity, turnaround time, and quality

  benchmarks.
• Participate in internal QA, audits, feedback sessions, and continuous improvement activities.

Required Qualifications:

• CCS or CRC certification required

• Risk adjustment/HCC coding experience

  (payer or provider environment)
• Strong knowledge of

  ICD-10-CM

  coding guidelines and compliant coding practices

• EHR experience

• Ability to interpret clinical documentation to support accurate diagnosis coding

Preferred Qualifications:

• Experience with

  post-visit/retrospective encounter coding

  in ambulatory/primary care settings
• Familiarity with

  CMS-HCC model concepts

  and risk-based coding workflows
• Exposure to coding quality programs and audit readiness practices

Core Skills & Competencies:

• High attention to detail with strong clinical reasoning
• Excellent time management and ability to handle volume efficiently
• Strong written communication and documentation skills
• Quality-focused mindset with adherence to compliance standards (HIPAA, client policies)

Tools & Systems:

• EHR/EMR systems

• Coding and risk adjustment tools/work queues (as applicable)
• Productivity and QA tracking tools (Excel/portals/dashboards)

Work Expectations / Metrics (Typical):

• Daily chart volume and TAT as assigned
• Accuracy and audit scores meeting defined thresholds
• Consistent documentation of coding rationale and actions taken