Medical Coder
Role Overview
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
Full Job Posting
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
About agilon health
Public U.S. healthcare company helping independent primary-care physicians deliver value-based care to seniors.
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