HCC QA Analyst

We Are Hiring \| HCC Quality Analyst

Location: Hyderabad / Work from Office

Employment Type: Full\-Time

Experience: 2–5 Years

We are looking for an experienced and detail\-oriented HCC Quality Analyst to review and audit medical coding charts for accuracy, compliance, and quality. The ideal candidate should have strong expertise in ICD\-10\-CM, CMS\-HCC Risk Adjustment coding guidelines, and auditing methodologies.

Key Responsibilities

✅ Perform quality audits on HCC/Risk Adjustment coded charts

✅ Validate ICD\-10\-CM code assignments based on CMS\-HCC guidelines and medical documentation

✅ Identify coding errors, documentation gaps \& compliance risks

✅ Provide feedback, coaching \& corrective action recommendations to coding teams

✅ Conduct error trend analysis and publish quality reports

✅ Ensure adherence to CMS guidelines, Coding Clinic updates, HIPAA regulations \& client requirements

✅ Participate in calibration sessions and quality improvement initiatives

✅ Maintain audit records, productivity reports \& quality dashboards

✅ Collaborate with Operations, Training \& Compliance teams to improve coding accuracy

✅ Stay updated with CMS\-HCC model changes, ICD\-10\-CM updates \& payer guidelines

Required Skills \& Qualifications

✔ Strong knowledge of ICD\-10\-CM coding guidelines \& CMS\-HCC Risk Adjustment model

✔ Hands\-on experience in HCC coding audits and quality analysis

✔ Good understanding of anatomy, physiology, medical terminology \& chronic conditions

✔ Strong analytical and communication skills

✔ Ability to identify over\-coding, under\-coding \& documentation deficiencies

✔ Proficiency in EMR/EHR systems and MS Excel

✔ Strong attention to detail and quality\-focused mindset

Eligibility Criteria

✔ Minimum 2–5 years of experience in HCC Coding

✔ Minimum 1 year of experience in Quality Analysis/Auditing preferred

✔ CPC / CRC / CCS certification from AAPC or AHIMA preferred/mandatory

✔ Graduation in Life Sciences, Pharmacy, Nursing, or related healthcare field preferred

✨ Preferred Qualifications

✔ Experience in Prospective, Retrospective, or Concurrent HCC audits

✔ Exposure to Medicare Advantage/Risk Adjustment projects

✔ Knowledge of productivity and quality metrics

✔ Experience in mentoring or training coders is an added advantage

Key Performance Indicators (KPIs)

⭐ Audit Accuracy %

⭐ Coding Quality Score

⭐ Error Rate Reduction

⭐ Productivity Targets

⭐ Compliance Adherence

⭐ Feedback Closure Rate

Benefits

✨ Competitive Salary

✨ Incentives \& Performance Bonuses

✨ Career Growth Opportunities

✨ ESI Benefits

Interested candidates can share their updated resume.

• *akshithasingampalli2005@gmail.com**

Pay: ₹256,528\.17 \- ₹1,214,390\.54 per year

Work Location: In person