Medical Coder

About the Company

AHIPL Agilon Health India Private Limited is hiring for the position of Medical Coder based in Bangalore, India.

Job Responsibilities

• Ensure diagnosis codes are accurate, complete, specific, and appropriate according to the services provided.
• Analyze medical records to identify all valid coding based on the CMS HCC model.
• Identify all proper HEDIS exclusion codes not included in the CMS HCC model from medical records.
• Examine medical records to determine all suitable CPT II procedure codes.
• Use medical coding software or reference tools to select correct codes.
• Record accurate claim and encounter information in the system.
• Use knowledge of anatomy and physiology to interpret clinical notes and assign relevant clinical codes.
• Exhibit analytical skills and problem-solving capabilities to overcome challenges in obtaining and verifying accurate HCC documentation.
• Maintain a detailed tracking system for all HCC activities ensuring timely completion of tasks.
• Conduct provider queries compliant with AHIMA/ACDIS standards when required.
• Incorporate feedback from post-query responses to finalize coding determinations.
• Engage in continuous training and education within the set timeframe.
• Stay informed about changes in coding standards, reimbursement guidelines, and regulations.
• Report operational issues and obstacles in work processes to leadership.
• Provide education and mentorship to enhance medical coding quality among peers.
• Contribute to special audit projects when requested.
• Perform any additional duties assigned by management.

Location

This role is based onsite in Bangalore, India.