Medical Coder Risk Adjustment Only

Chennai (Hybrid)

Experience: 45 Years

Invent Health Inc

Invent Health is a Silicon Valleybased healthcare analytics company focused on Risk Adjustment, Coding Intelligence, and NLP-powered chart review solutions. We support leading U.S. health plans across Medicare Advantage, Medicaid, and ACA, processing over 5.5M+ member lives annually.

We are expanding our Chennai team and hiring an experiencedRisk Adjustment Medical Coder with strong RADV audit expertisewho is comfortable working in a technology-enabled coding environment.

This role requires deep expertise in risk adjustment coding and RADV audit validation. You will work extensively onInvent Healths proprietary NLP-powered Coder Workbench, leveraging AI-assisted insights while applying your clinical judgment to ensure CMS-compliant, audit-ready coding.

This is NOT a traditional manual coding role we are looking for coders who can effectively use intelligent tools and maintain high accuracy under audit scrutiny.

Perform detailed chart reviews for Medicare Advantage (CMS-HCC V24 & V28) and applicable LOB's.

Conduct RADV-level validation and documentation review

Validate HCC capture, deletions, and documentation support

Ensure adherence to CMS guidelines, ICD-10-CM Official Guidelines & MEAT criteria

Work extensively within IHs proprietary NLP-enabled Coder Workbench

Review and validate NLP-suggested codes with high precision

Identify unsupported diagnoses and documentation gaps

Support internal QA and audit preparedness initiatives

Analyze coding trends and contribute to quality improvement efforts

Maintain strict HIPAA & PHI compliance

45 years of Risk Adjustment Coding experience (Medicare Advantage mandatory)

Hands-on RADV audit experience

Strong understanding of CMS-HCC model (V24; V28 knowledge preferred)

Active certification: CRC / CPC / CCS (CRC preferred)

Strong knowledge of:

RADV medical record validation

MEAT criteria

ICD-10-CM Official Guidelines

CMS documentation standards

Comfortable working in AI/NLP-assisted coding platforms

Experience reviewing large medical records (100+ page charts)

Strong analytical and documentation interpretation skills

Experience with technology-enabled coding platforms or coder workbench tools

Exposure to QA frameworks and second-level audit reviews

Experience supporting U.S. health plans

Understanding of encounter data submission (837 exposure is a plus)