Medical Coder
agilon healthBengaluru, Karnataka, India
Posted April 1, 2026
Full Time
About the Company
agilon health is transforming health care for seniors by empowering primary-care physicians to focus on the entire health of their patients. Through our platform and partnership model, agilon health is leading the nation in creating the system we need – one built on the value of care, not the volume of fees. We honor the independence of local physicians and serve as their long-term partner so they can be the physicians they trained to be. agilon is built for physicians by physicians, as the patient-physician relationship is the cornerstone of care. We allow primary care physicians to take the long view of their relationships with patients, and to be confident in the long-term financial viability of their own practices. We do this through a Total Care Model that maintains the independence of physicians; unites them in a network of like-minded leaders; and integrates all of the components of a global risk business model into a single platform.
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.
Requirements
- 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
