Job Description

Company: AHIPL Agilon Health India Private Limited

Job Posting Location: India_Bangalore

Job Title: Coding Quality Auditor

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  Essential Job Functions:
  • Performs coding audits providing expert coding and documentation education, timely feedback and coaching.
  • Performs expert level review of submitted visit notes; identifies gaps in clinical documentation that may require additional education.
  • Conducts review and communicates feedback to professionals such as Clinical Chart Reviewers, market coders and third-party vendors.
  • Responds to coding questions submitted by market coders.
  • Evaluates documentation to ensure diagnosis coding is supported, meets specificity requirements to support clinical indicators and in compliance with Risk Adjustment documentation standards.
    • Review and analysis of clinical documentation for missed HCC coding opportunities
    • Review and analysis of clinical documentation for unsupported HCC coding
  • Document detailed chart audit findings including all coding and documentation errors as well as any potential HCC opportunities
  • Audits Coder queries to ensure verbiage is AHIMA compliant.
  • Correlate activities, processes and HCC results/ metrics to evaluate outcomes.
  • Assist in developing workflows and policies and procedures related to the Coding Department
  
  
  Other Job Functions:
  • Understand, adhere to, and implement the Company\xe2\x80\x99s policies and procedures.
  • Provide excellent customer services skills, including consistently displaying awareness and sensitivity to the needs of internal and/or external clients. Proactively ensuring that these needs are met or exceeded.
  • Take personal responsibility for personal growth including acquiring new skills, knowledge, and information.
  • Engage in excellent communication which includes listening attentively and speaking professionally.
  • Set and complete challenging goals.
  • Demonstrate attention to detail and accuracy in work product.
  • Other duties as assigned by manager
  
  
  Required Qualifications:
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    Minimum Experience
  
  
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  At least 2-4 years of risk adjustment coding and/or auditing experience
  
  Education/Licensure:
  • Minimum of High School Diploma, Bachelor\xe2\x80\x99s Degree preferred
  • Coding Certification (CCS, or CPC/CRC through AHIMA/AAPC) required
  
  
  Skills and Abilities:
  Language Skills: Strong communication skills both written and verbal to work with multiple internal and external clients in a fast-paced environment Mathematical Skills: Ability to work with mathematical concepts such as probability and statistical inference. Ability to apply concepts such as fractions, percentages, ratios, and proportions to practical situations. Reasoning Ability: Ability to apply principles of logical or scientific thinking to a wide range of intellectual and practical problems. Computer Skills: Ability to create and maintain documents using Microsoft Office (Word, Excel, Outlook, PowerPoint)