Open to opportunities

Agha Asif DURRANI

@aghaasifdurrani

I’m a detail-oriented Risk Adjustment Coder and Auditor specializing in Medicaid/Medicare and HCC capture for compliant reimbursement.

United States

Message

What I'm looking for

I’m looking for remote risk adjustment and coding work where I can deliver accurate HCC/RADV results, maintain strong coding accuracy, and support CMS/HIPAA-compliant documentation and auditing across multiple specialties.

I’m a detail-oriented Risk Adjustment Coder and Auditor with over 9 years of experience specializing in Medicaid and Medicare coding, HCC coding, RADV audits, and outpatient/ED encounter review.

Across Primary Care, Cardiology, Oncology, Nephrology, OB-GYN, and surgical services, I accurately analyze and code complex medical records to ensure full compliance with CMS guidelines and regulatory standards.

I bring proven expertise in HCC risk adjustment methodologies for reimbursement, including accurate HCC capture for outpatient and emergency department encounters and coding for Medicare Advantage populations using ICD-10-CM guidelines.

In remote roles at Optum (United Health Group), Wellerhit, GDIT, Agilon Health, Apixio (Comforce Health), Maxim Health Care, and Inovalon NY, I support high-quality results through strong knowledge of ICD-10-CM, CPT-4, HCPCS Level II, DRGs, CMS/ HIPAA requirements, and tools like 3M CodeFinder—maintaining accuracy standards (e.g., 95%) and continuously reducing coding errors.

Experience

Work history, roles, and key accomplishments

Current

Risk Adjustment Coder

Current

Optum

Aug 2024 - Present (1 year 9 months)

Reviewed, analyzed, and coded diagnoses per ICD-10 and CMS guidelines for Medicaid and Medicare risk adjustment. Performed HCC capture and auditing for outpatient and emergency department (ED) encounters using 3M CodeFinder while adhering to HIPAA and company compliance standards.

ICD 10 CM HCPCS Level II HCC Risk Adjustment Outpatient Coding Coding Guidelines HIPAA compliance Epic

Risk Adjustment & RADV Coder

Wellerhit

Aug 2023 - Jul 2024 (11 months)

Reduced CMS submission errors for HCC coding by reviewing and coding diagnoses using ICD-10 and DRG guidelines. Maintained a 95% coding accuracy rate while completing risk adjustment and RADV-related coding audits for Medicare Advantage populations.

HCC Coding RADV Audit DRG Coding ICD 10 CM Coding Guidelines HIPAA compliance Coding Accuracy Risk Adjustment Coding

Medical Coder

Gdit

Aug 2022 - Jul 2023 (11 months)

Worked on Medicaid and Medicare medical coding projects covering primary care, E&M, cardiology, OB-GYN, oncology, nephrology, surgeries, and diagnostic testing. Ensured compliance with CMS, HIPAA, and JCAHO requirements while coding using ICD-10-CM, CPT-4, and HCPCS Level II.

ICD 10 CM CPT HCPCS Level II E M Coding HIPAA compliance JCAHO Medical Record Review

E&M and Risk Adjustment Coder

Agilon Health

May 2020 - Jul 2022 (2 years 2 months)

Reviewed and coded diagnoses using ICD-10 and DRG coding guidelines for E&M and risk adjustment workflows. Performed HCC-based remote coding across multiple specialties while maintaining compliance with CMS, HIPAA, and JCAHO requirements.

E M Coding HCC Risk Adjustment DRG Coding ICD 10 CM HCPCS Level II Coding Guidelines HIPAA compliance JCAHO Medical Record Review

HCC Coder

Comforce Health - Apixio

Oct 2019 - Apr 2020 (6 months)

Seasonal HCC coder responsible for reviewing charts for chronic conditions and abstracting risk-adjusting conditions. Coded according to official coding guidelines, supported quality improvement initiatives, and maintained an accuracy standard of more than 95%.

HCC Coding ICD 10 CM HCPCS Level II Coding Guidelines Quality Improvement HIPAA compliance

HCC PACE Remote Coder

Maxim Health Care

Apr 2019 - Oct 2019 (6 months)

Worked on reimbursement-focused remote HCC coding for a PACE project across multiple medical and surgical specialties. Ensured compliance with CMS policies, HIPAA regulations, and JCAHO requirements while coding medical records using ICD-10-CM, CPT-4, and HCPCS Level II.

HCC Coding ICD 10 CM CPT HCPCS Level II HIPAA compliance JCAHO

Medical Chart Reviewer

Inovalon Ny

Sep 2017 - Mar 2019 (1 year 6 months)

Performed HEDIS medical chart review by verifying the accuracy, completeness, and appropriateness of diagnosis codes against documentation. Conducted quality audits and retrospective chart reviews (including HCC-related components) while performing medical record retrieval and uploading relevant scanned records using EMR software.

HEDIS Chart Review Quality Audits HIPAA compliance Medical Record Retrieval Medical Terminology