Job Role:
The HCC Coder is responsible for accurately coding and validating
diagnoses and procedures for Hierarchical Condition Categories (HCC) coding. This role
plays a vital role in ensuring proper documentation and coding, which directly impacts
reimbursement and compliance. The HCC Coder ensures compliance with coding
guidelines, conducts audits, and provides education and support to the healthcare team.
Responsibilities:
 Analyse medical records to identify and assign appropriate ICD-10 codes for HCC
coding
 Review documentation to ensure accurate capture of all relevant diagnoses and
procedures
 Conduct comprehensive assessments of medical record documentation to ensure
compliant coding
 Collaborate with healthcare providers and medical coders to clarify documentation or
obtain additional information as needed
 Verify the accuracy and completeness of coded data, ensuring adherence to coding
guidelines and conventions
 Perform regular audits of coding quality, identifying trends, and recommending
process improvements
 Stay updated on coding guidelines, HCC coding updates, and reimbursement policies
to ensure compliance.
 Provide feedback and education to healthcare providers and staff on coding best
practices and documentation requirements.
 Maintain a high level of accuracy while meeting productivity targets and deadlines.
 Collaborate with revenue cycle management and billing teams to resolve codingrelated
billing denials and ensure timely reimbursement
 Maintain confidentiality and adhere to all HIPAA regulations and privacy guidelines.
 Proficiency with coding software, electronic health records (EHR), and other relevant
software applications

Qualifications:
Education: Bachelor’s Degree in any life science
Licences/Certifications: CPC/COC/CRC/CCS/CIC
 Demonstrate analytical and problem-solving ability regarding barriers to receiving
and validating accurate HCC information.
 1+ years experience in HCC coding
 Proficiency in ICD-10 coding, including HCC coding methodologies and Risk
adjustment coding guidelines.
 Knowledge of Medicare Risk Adjustment (MRA) and Hierarchical Condition
Categories (HCC) coding concepts
 Excellent written and verbal communication skills to interact with healthcare
providers and staff