Review Medical Records Thoroughly
Analyze patient charts, physician notes, lab results, and clinical documentation.
Identify chronic conditions, comorbidities, and other relevant diagnoses for HCC risk scoring.
Assign Accurate Codes
Apply
ICD-10-CM
,
CPC
,
CRC
, and
HCC coding standards
to ensure precise representation of patient conditions.
Ensure correct sequencing of primary and secondary diagnoses.
Risk Adjustment & Compliance
Follow CMS HCC risk adjustment guidelines for Medicare Advantage and other risk-adjusted programs.
Ensure full compliance with HIPAA, coding compliance rules, and company policies.
Documentation Validation & Clarification
Review physician documentation to confirm coding accuracy.
Query providers for missing or unclear documentation when necessary.
Support Audits & Reporting
Prepare and submit coding reports for internal and external audits.
Correct coding discrepancies and implement feedback to maintain quality standards.
Optimize Risk Capture
Identify patterns or gaps in documentation to improve risk adjustment and revenue accuracy.
Collaborate with care management teams to ensure high-quality coding.
Maintain Confidentiality
Handle patient health information with strict adherence to HIPAA guidelines.
Ensure secure storage and transmission of sensitive data.
Continuous Learning & Updates
Stay current with coding updates, CMS rules, and HCC risk adjustment changes.
Attend training sessions to maintain certifications and coding accuracy.

More Jobs at Complivorks

Hcc Medical Coder

bengaluru

2.0 - 7.0 yrs

INR 4 - 9 Lacs

Hcc Medical Coder

hyderabad

1.0 - 6.0 yrs

INR 3 - 12 Lacs

Hcc Medical Coder

chennai

2.0 - 7.0 yrs

INR 3 - 12 Lacs

Mock Interview

Practice Video Interview with JobPe AI

Start Job-Specific Interview

Start Your Job Search Today

Browse through a variety of job opportunities tailored to your skills and preferences. Filter by location, experience, salary, and more to find your perfect fit.