Prospective Chart Review Quality Auditor

3 days ago

Bengaluru Karnataka, India Agilon Health Full time

Company:
AHIPL Agilon Health India Private Limited

Job Posting Location:
India_Bangalore

Job Title:
Prospective Chart Review Quality Auditor

Job Description:

- Performs audits of pre-visit medical record reviews to identify chronic conditions reported in prior years and conditions that lack supporting documentation.
- Evaluates suggestions or clinical alerts presented by Prospective Chart reviewers, ensure that these suggestions meet specificity requirements to support clinical indicators and in compliance with Risk Adjustment documentation standards.
- Conducts review and communicates feedback to professionals such as Clinical Chart Reviewers and third-party vendors.
- Responds to questions submitted by Prospective Chart reviewers.
- Document detailed audit findings including all errors and missed opportunities in the Prospective chart reviews.
- Correlate activities, processes and HCC results/ metrics to evaluate outcomes.
- Assist in developing workflows, curriculum and policies and procedures related to the Pre-visit Medical Record review team.

Other Job Functions:

- Understand, adhere to, and implement the Company’s 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.

Required Qualifications:
Minimum Experience
- 2+ years of clinical experience required
- 5+ year of chart review and medical coding/auditing experience required
- Advanced level of clinical knowledge associated with chronic disease states required

Education/Licensure:

- Medical doctor or Nurse required
- Coding Certification through AHIMA or AAPC required
- CPC or CPMA preferred

Skills and Abilities:
Location:
India_Bangalore

  • Prospective Chart Reviewer

    1 week ago

    Bengaluru, Karnataka, India Agilon Health Full time

    Company: AHIPL Agilon Health India Private Limited Job Posting Location: India_Bangalore Job Title: Prospective Chart Reviewer **Job Description**: Essential Job Functions: - Performs pre-visit medical record reviews to identify chronic conditions reported in prior years - Identify diagnoses that lack supporting documentation - Prioritizes clinical...

  • Prospective Chart Reviewer

    3 days ago

    Bengaluru, India Agilon Health Full time

    Company: AHIPL Agilon Health India Private Limited Job Posting Location: India_Bangalore Job Title: Prospective Chart Reviewer **Job Description**: Essential Job Functions: - Performs pre-visit medical record reviews to identify chronic conditions reported in prior years - Identify diagnoses that lack supporting documentation - Prioritizes clinical...

  • Urgent Search: Prospective Chart Reviewer

    3 weeks ago

    Bengaluru, Karnataka, India Randstad Full time

    this job offer closes 3 july 2025summary bengaluru karnataka a client of randstad india posted 3 may 2025reference number JPC - 107703next stepsjob detailsPosition Summary Prospective chart reviewers help to identify clinical alerts in a patients history that may support an underlying diagnosis These alerts are presented to a provider on a...

  • chart reviewer

    3 weeks ago

    Bengaluru, Karnataka, India Randstad Full time

    Position Summary:Prospective chart reviewers help to identify clinical alerts in a patients' history that may support an underlying diagnosis. These alerts are presented to a provider on a point-of-care tool to use during an encounter. This allows the condition to be addressed bythe clinician.Essential Job Functions:· Performs pre-visit medical record...

  • Coding Quality Auditor

    3 days ago

    Bengaluru, India Agilon Health Full time

    Company: AHIPL Agilon Health India Private Limited Job Posting Location: India_Bangalore Job Title: Coding Quality Auditor **Job Description**: - 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...

  • Coding Quality Auditor-3

    3 days ago

    Bengaluru, India Agilon Health Full time

    Company: AHIPL Agilon Health India Private Limited Job Posting Location: India_Bangalore Job Title: Coding Quality Auditor-3 **Job Description**: 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...

  • Quality Professional

    7 days ago

    Bengaluru, India Siemens Healthineers Full time

    **Responsibilities**: - Support the audit program manager in definition and implementation of comprehensive audit programs and audit methodologies to effectively address identified risks - Interact with stakeholders at all levels in developing comprehensive audit plan and execution of planned audits - Perform audits for the various products /suppliers...

  • Quality Professional

    15 hours ago

    Bengaluru, India Siemens Healthineers Full time

    **Responsibilities**: - Support the audit program manager in definition and implementation of comprehensive audit programs and audit methodologies to effectively address identified risks - Interact with stakeholders at all levels in developing comprehensive audit plan and execution of planned audits - Perform audits for the various products /suppliers...

  • IT Auditor

    3 days ago

    Bengaluru, Karnataka, India Finastra USA Corporation Full time

    Overview: Job Title - Audit Generalist **Responsibilities**: **What will you contribute?** Internal Auditor - Information Technology Job Summary The Internal Auditor plays a key role in a dynamic, Global Financial Technology (FinTech) Company, partnering with the business to ensure risks are recognized and appropriately managed. The role is responsible...

  • Internal Auditor

    1 week ago

    Bengaluru, Karnataka, India Antique Network Solution Pvt.Ltd Full time

    Internal Auditor - Job description - Payfin - If numbers, audits, and compliance excite you, you’re exactly who we’re looking for! - Location: JP Nagar Phase 1, Bengaluru , Work in Office We are a growing fintech startup enabling businesses to manage collections, payouts, and financial operations with speed and security. As we scale, we are...