Job Description

2 - 3 Years
2 Openings
Kochi, Trivandrum

Role description

The Certified MRA Coder I performs

retrospective reviews

of medical records to abstract

ICD-10-CM diagnosis codes

in alignment with

Risk Adjustment program

requirements. The goal is to accurately capture the health plan members' burden of illness and support proper documentation for

Commercial, Medicare, and Medicaid

Risk Adjustment Programs.

Primary Responsibilities

Ensure compliance with all applicable federal laws and regulations related to coding and documentation for Risk Adjustment Programs. Conduct

remote medical record reviews

to identify and capture relevant diagnosis codes that fall under

Hierarchical Condition Categories (HCC)

. Perform

two-way reviews

by auditing claims data and removing unsupported ICD-10-CM codes. Validate that all diagnosis codes are fully supported by medical documentation and compliant with ICD-10-CM Official Guidelines and client-specific coding instructions. Maintain coding quality, accuracy, and productivity metrics as defined by the organization.

Employment Qualifications

Education & Certification (Required):

High school diploma or equivalent. Completion of a certified medical coding program.
Acceptable certifications include:


+ CPC, COC, CRC (AAPC)
+ CCS, CCS-P (AHIMA)
+ CPC-A with required experience is acceptable.
Active certification and continuing education/membership maintenance required.

Experience:

Minimum

2 years of HCC risk adjustment coding experience

, or

1 year of general medical coding

experience with

2 years of clinical-related healthcare

experience.

Skills, Knowledge & Abilities (SKA)

In-depth understanding of

Risk Adjustment programs

, including coding and data validation requirements. Strong knowledge of

ICD-10-CM coding guidelines

and AHA Coding Clinic guidance. Advanced understanding of

medical terminology

,

pharmacology

,

anatomy/physiology

, and

disease pathology

. Ability to work efficiently across multiple

lines of business

, coding platforms, and EMR systems. Excellent

time management

and the ability to meet deadlines with minimal supervision. Strong attention to detail with a high level of

accuracy

,

completeness

, and

production efficiency

. Clear and professional communication skills, both written and verbal.

Skills

Risk Adjustments programs coding and data Validation,Medical Terminology,Pharmacology

About UST

UST is a global digital transformation solutions provider. For more than 20 years, UST has worked side by side with the world's best companies to make a real impact through transformation. Powered by technology, inspired by people and led by purpose, UST partners with their clients from design to operation. With deep domain expertise and a future-proof philosophy, UST embeds innovation and agility into their clients' organizations. With over 30,000 employees in 30 countries, UST builds for boundless impact--touching billions of lives in the process.