About this role
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