Medical Coder Risk Adjustment Only

Medical Coder – Risk Adjustment (RADV Audit Specialist) Chennai (Hybrid) Experience: 4–5 Years Invent Health Inc

Invent Health is a Silicon Valley–based 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 experienced

Risk Adjustment Medical Coder with strong RADV audit expertise

who is comfortable working in a technology-enabled coding environment. Role Overview This role requires deep expertise in risk adjustment coding and RADV audit validation. You will work extensively on

Invent Health’s 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. Key Responsibilities • 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 IH’s 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 Required Qualifications • 4–5 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 Preferred • 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)