mohsin khan

I’m a detail-oriented, CPC-certified Medical Coding professional with a specialized focus on HCC Risk Adjustment and ICD-10-CM precision. I bring 10 years of experience validating clinical documentation and translating it into accurate, compliant codes that support better risk capture.

In my current role as an HCC (Hierarchical Condition Category) Coder, I perform comprehensive retrospective and prospective reviews of outpatient medical records to identify relevant chronic conditions. I assign ICD-10-CM codes in strict accordance with CMS (Centers for Medicare & Medicaid Services) and official coding guidelines, ensuring every diagnosis meets MEAT (Monitor, Evaluate, Assess, Treat) or TAMPER requirements for substantiation.

I optimize RAF (Risk Adjustment Factor) scores by analyzing medical data so complexity and patient health status are accurately reflected. I also support Risk Adjustment Data Validation (RADV) audits by retrieving and verifying supporting documentation, and I stay current with annual updates to the HCC Risk Adjustment Model, including transitions between model versions (e.g., v24 to v28).

Across audits and day-to-day chart reviews, I maintain high compliance and data integrity—monitoring HIPAA regulations, using regular internal audits and peer reviews, and initiating professional physician queries when documentation is missing or vague. Before coding, I built strong clinical workflow expertise as a Pharmacist and Senior Pharmacist, strengthening my ability to review orders, maintain medication safety, and collaborate with healthcare teams to reduce claim denials and improve quality-of-care.