Medical Coder HCC CDI Specialist

Position Overview

We are seeking a certified Medical Coder with expertise in HCC (Hierarchical Condition Category) and Clinical Documentation Improvement (CDI), along with proven experience in payer projects. The role focuses on ensuring accurate risk adjustment coding, strengthening documentation quality, and supporting compliance within US healthcare frameworks.

Job Description

Key Responsibilities

• Perform accurate HCC coding using ICD-10-CM, ensuring proper capture of chronic conditions and RAF impact.
• Drive Clinical Documentation Improvement (CDI) by identifying gaps and raising compliant queries.
• Work on payer projects, including chart reviews, RADV audits, and risk adjustment validation.
• Ensure adherence to CMS guidelines, compliance standards, and audit requirements.
• Collaborate with cross-functional teams while meeting quality and productivity targets.

Required Qualifications & Skills

Education & Certification (Mandatory)

• Certified coder: CPC / CCS / CRC (AAPC/AHIMA)
• Life Sciences / Medical background preferred

Experience

• 25+ years of HCC coding & CDI experience
• Hands-on experience in payer projects (Mandatory)
• Experience in US Healthcare / Risk Adjustment coding

Technical Competencies

• Strong knowledge of ICD-10-CM, HCC model, and CMS guidelines
• Familiarity with CDI processes & physician query workflow
• Experience working with EMR/EHR systems and coding tools

Soft Skills

• Strong analytical and attention to detail
• Excellent communication and stakeholder interaction skills
• Ability to manage high volumes with accuracy and efficiency

Recruiter:-V.DeviSri

Contact:-95810421119

Email:-devisri.vaddadhi@datamarshall.com