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Coding Quality Auditor

2 weeks ago

Bengaluru, India Agilon Health Full time

Company:
AHIPL Agilon Health India Private Limited

**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 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’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.
- Other duties as assigned by manager
- Required Qualifications:Minimum Experience
At least 2-4 years of risk adjustment coding and/or auditing experience- Education/Licensure:
- Minimum of High School Diploma, Bachelor’s 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-
- _Computer Skills: _Ability to create and maintain documents using Microsoft Office (Word, Excel, Outlook, PowerPoint)