HCC Coder

An HCC (Hierarchical Condition Category) Coder job description typically involves accurately coding patient diagnoses using ICD-10 codes and mapping them to HCCs to support risk adjustment and reimbursement processes. This role ensures compliance with coding guidelines and regulations, identifies documentation deficiencies, and collaborates with healthcare providers to improve coding accuracy.
Key Responsibilities of an HCC Coder:
Accurate Coding:
Review and code medical records, assigning diagnoses using ICD-10 codes and mapping them to Hierarchical Condition Categories (HCCs).
Compliance:
Ensure adherence to coding guidelines and regulations, including those from the Centers for Medicare & Medicaid Services (CMS).
Documentation Review:
Analyze medical records to identify documentation deficiencies and discrepancies in coding.
Collaboration:
Collaborate with healthcare providers to clarify documentation and address any issues.
Feedback and Recommendations:
Provide feedback and recommendations to improve coding accuracy and documentation practices.
Quality Assurance:
May be involved in quality assurance activities, such as auditing and peer review of coding.
Risk Adjustment:
Contribute to the risk adjustment process by accurately coding diagnoses, which impacts reimbursement for healthcare providers.
Skills and Qualifications:
Medical Coding Certification: Possessing a medical coding certification (e.g., CPC, CCA) is often required or preferred.
ICD-10 Coding Knowledge: Strong understanding of ICD-10 coding guidelines and procedures.
HCC Coding Experience: Experience with HCC coding and risk adjustment is crucial.
Medical Terminology: Familiarity with medical terminology and anatomy.
Attention to Detail: Accuracy and precision are essential for accurate coding.
Analytical Skills: Ability to analyze medical records and identify coding discrepancies.
Communication Skills: Ability to communicate effectively with healthcare providers and other staff.
Knowledge of HIPAA and Compliance: Understanding of HIPAA regulations and other compliance requirements.
In summary, an HCC Coder plays a vital role in ensuring the accuracy and compliance of medical coding, which directly impacts risk adjustment and reimbursement for healthcare providers.

HCC Coder
Experience:2 to 5 years
Non certified coders
Location: Chennai