Prospective Chart Review Quality Auditor
agilon healthBengaluru, Karnataka, India
Posted June 3, 2025
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
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.
Requirements
- Minimum 2+ years of clinical experience
- 5+ year of chart review and medical coding/auditing experience
- Advanced level of clinical knowledge associated with chronic disease states
- Medical doctor or Nurse required
- Coding Certification through AHIMA or AAPC required
- CPC or CPMA preferred
