Medical Coder

agilon health


Date: 5 hours ago
City: Remote, Remote
Contract type: Full time
Remote
Company:

AHIPL Agilon Health India Private Limited

Job Posting Location:

India_Bangalore

Job Title:

Medical Coder

Job Description:

Primary responsibilities:

  • Verify and ensure the accuracy, completeness, specificity, and appropriateness of diagnosis codes based on services rendered.
  • Review medical record information to identify all appropriate coding based on CMS HCC model.
  • Review medical record information to identify all appropriate HEDIS exclusion codes that do not map in the CMS HCC model.
  • Review medical record information to identify all appropriate CPT II procedure coding
  • Utilize medical coding software programs or reference materials to identify appropriate codes
  • Complete appropriate system entry regarding claim/encounter information.
  • Apply understanding of basic anatomy and physiology to interpret clinical documentation and identify applicable clinical codes
  • Demonstrate analytical and problem-solving ability regarding barriers to receiving and validating accurate HCC information.
  • Maintain a comprehensive tracking and management tool to track all HCC activities and ensure that all tasks are completed in a timely manner.
  • Performs AHIMA/ACDIS compliant queries to providers when necessary
  • Apply post-query response to make final determination
  • Participate in ongoing training and education within assigned timeframe
  • Maintains up-to-date knowledge of changes in coding and reimbursement guidelines and regulations
  • Communicates to leadership issues and barriers to completing all work processesEducate and mentor others to improve medical coding quality

May participate in special project auditing as required

  • All other duties as assigned by leadership

Location:

India_Bangalore

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