CRC / CPC Medical Coder

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.