Risk Adjustment Coder

Reveleer
Chennai
Workplace: OnsiteFull timeFunction: Software EngineeringExperience: 2+ yearsSkills: ["Analytical ability","Attention to detail","Communication skills","Written skills","Accuracy/compliance focus"]

Review and analyze clinical documentation to assign accurate ICD-10-CM diagnoses for Risk Adjustment (HCC) models. Ensure coding accuracy aligned with CMS, DX-HCC, and internal compliance guidelines, validating documentation to support submitted diagnoses and flagging gaps. Collaborate with QA and clinical teams to resolve coding discrepancies, maintain productivity and audit readiness, and participate in continuous audits, feedback, and training. Handle work with HIPAA-compliant confidentiality.

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Reveleer
Reveleer
17 hours ago

Risk Adjustment Coder

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Last checked: 7 hours agoStatus: Live

Job Summary

Review and analyze clinical documentation to assign accurate ICD-10-CM diagnoses for Risk Adjustment (HCC) models. Ensure coding accuracy aligned with CMS, DX-HCC, and internal compliance guidelines, validating documentation to support submitted diagnoses and flagging gaps. Collaborate with QA and clinical teams to resolve coding discrepancies, maintain productivity and audit readiness, and participate in continuous audits, feedback, and training. Handle work with HIPAA-compliant confidentiality.
Location: Chennai
Workplace: Onsite
Employment Type: Full time
Job Function: Software Engineering
Seniority: Mid level

Key Responsibilities

  • •Review and analyze medical records and documentation to assign accurate ICD-10-CM diagnosis codes for Risk Adjustment (HCC) models.
  • •Ensure coding accuracy aligned with CMS, DX-HCC, and internal compliance guidelines.
  • •Validate clinical documentation to support submitted diagnoses and identify documentation gaps.
  • •Work with QA/clinical teams to resolve coding queries and discrepancies.
  • •Participate in continuous audits, feedback sessions, and training to improve coding quality and identify documentation improvement opportunities.

Key Requirements

  • •CRC or CPC certification is mandatory.
  • •2+ years of experience in Risk Adjustment / HCC coding.
  • •Bachelor’s degree in Life Sciences, Nursing, Pharmacy, or related field.
  • •Strong knowledge of CMS risk adjustment models, ICD-10 guidelines, and clinical terminology.
  • •Ability to accurately interpret physician documentation for coding and documentation support.
Experience:2+ years
Education:
Skills:Analytical abilityAttention to detailCommunication skillsWritten skillsAccuracy/compliance focus
Certifications:CRCCPC
Tech Stack:HCC codingCMS guidelinesRAF score calculationICD-10-CMDX-HCCEMR/EHR systemsCoding platformsHIPAA

Company Brief

Reveleer
Provides an AI-powered value-based care platform for health plans and risk-bearing providers, offering retrieval, clinical intelligence, risk adjustment, quality improvement, and member management solutions to streamline workflows and improve outcomes.
Industry: HealthTech
Company Size: Large (251 to 1,000 employees)
Growth: Scaleup
Funding: Private Equity Backed
Headquarters: Glendale, United States
Founded: 2009
Glassdoor
Glassdoor: 4.2
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