Medical Coder

Agilon Health, Inc.; Bengaluru; On-site; INR 300,000 - 540,000; Full time

Job summary

AHIPL Agilon Health India Private Limited seeks a Medical Coder in Bengaluru to ensure accurate diagnosis coding from patient records. You will review CMS HCC models, CPT II codes, and HEDIS exclusions, and apply coding software to assign the correct codes for claims.

You will maintain documentation, perform post-query resolution with providers, and stay updated on coding guidelines and reimbursement changes to support compliant, timely claim processing.

Qualifications

• Proficient in clinical documentation and coding practices.
• Knowledge of CMS HCC model and CPT coding conventions.
• Ability to interpret medical records and assign accurate codes.

Responsibilities

• Verify and assign diagnosis codes based on services rendered.
• Review records for CMS HCC and CPT II coding.
• Enter claim/encounter information into systems and maintain traceability.
• Stay updated on coding guidelines and reimbursement changes.

Skills

Medical coding

HCC coding

CPT II coding

HEDIS concepts

CMS guidelines

Tools

Coding software

Job description

Company: AHIPL Agilon Health India Private Limited

Job Posting Location: India_Bangalore

Job Title: Medical Coder

Job Description

• 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 processes
• Educate 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

PASSION & PURPOSE

The passion to change the way healthcare is delivered permeates everyone and everything at agilon health. Working together we can use our expertise to make a difference in the lives of patients and physicians alike. We can bring the joy back to practicing medicine for physicians and improve the care experience for patients across the country.

PRIVACY & TRUST

We value your privacy and trust as much and are committed to protecting your personal information and respecting your choices. We use technology and best practices to ensure that your data is secure and compliant with applicable laws and regulations. We also provide you with clear and transparent information about how we collect, use, and share your data, and how you can access, update, or delete it. You can read our full privacy policy click here

EQUAL OPPORTUNITY EMPLOYER

agilon health is committed to excellence through diversity. We are an equal opportunity employer and we will not discriminate against employees or qualified applicants for employment regardless of race; color; religion; genetic information; national origin; sex; pregnancy, childbirth, or related medical conditions; age; disability; citizenship status; uniform service member status; or any other protected class under federal, state, or local law. We strive to develop leaders and build future talent pools to help us meet the needs of our customers. If you need assistance or an accommodation due to a disability, you may email us at [e-mail].