Veradigm®
Veradigm®
Veradigm® प्रदाताओं, भुगतानकर्ताओं और जीवन-विज्ञान संगठनों के लिए क्लाउड-आधारित स्वास्थ्य-तकनीक विकसित करता है। इसका कनेक्टेड प्लेटफ़ॉर्म इलेक्ट्रॉनिक स्वास्थ्य अभिलेख, प्रैक्टिस प्रबंधन, राजस्व चक्र सेवाएँ, ई-प्रिस्क्राइबिंग, डेटा विनिमय, API, एनालिटिक्स, वास्तविक दुनिया के डेटा और साक्ष्य उपकरण, गुणवत्ता और जोखिम-समायोजन समाधान तथा रोगी सहभागिता क्षमताओं सहित क्लिनिकल और वित्तीय सॉफ़्टवेयर को एक साथ लाता है। Veradigm Network के माध्यम से ये उत्पाद पूरे स्वास्थ्य-सेवा पारिस्थितिकी तंत्र में देखभाल प्रदान करने, स्वास्थ्य-सेवा संचालन और अनुसंधान में सहायता करते हैं।

Medical Coding Audit Manager – Pune, India (Hybrid)

Lead Veradigm’s medical coding evaluation function and distributed team of certified coders. Set clinical scoring standards, audit AI-generated coding for accuracy, and report quality and risk metrics to stakeholders.

विवरण

  • Oversee daily operations for Veradigm’s Medical Coding Evaluation team supporting enterprise coding programs
  • Assess AI-generated coding against clinical documentation to verify code support, billability, and accuracy
  • Create and maintain scoring guidance in partnership with clinical specialists
  • Assign reviewers and manage priorities, capacity, and evaluation throughput
  • Resolve disagreements between reviewers and record the supporting rationale
  • Monitor agreement among reviewers and improve evaluation guidance as needed
  • Lead calibration exercises and assess readiness for scaled evaluations
  • Present clinical performance, accuracy, claims inclusion, and risk-effect metrics to leadership, product teams, and clients
  • Develop specialty coverage plans, starting with internal medicine
  • Broaden evaluation activities to include chart preparation and clinical note quality
  • Test automated scoring through sample reviews and report differences from expert assessments
  • Organize evaluations with design partners
  • Apply approved data-access limits, authorized data tiers, and compliant review tools
  • Recruit, mentor, and develop a distributed team of certified coders

आवश्यकताएँ

  • Bachelor’s degree in health information management, healthcare administration, or comparable technical or business experience
  • At least 8 years of relevant experience, including 2–3 years at expert level or equivalent experience preferred
  • Four years of ICD-10-CM, CPT, and HCPCS coding across multiple specialties, with strong attention to detail and consistently high accuracy
  • Two years of coding audit or coding quality-review experience
  • Two years of outpatient or ambulatory coding experience in a multispecialty or large-group practice
  • One year developing coding guidelines, audit criteria, or annotation standards for use by other reviewers
  • One year reviewing automated or computer-assisted coding output or performing comparable structured annotation work
  • Medicare Risk Adjustment or HCC coding experience preferred
  • Two to four years of relevant leadership experience, preferably managing distributed or remote teams
  • Active CPC, CCS, or CCS-P certification through AAPC or AHIMA required
  • CPMA certification preferred
  • CRC certification preferred
  • Expert knowledge of medical coding, including ICD-10-CM, CPT, HCPCS Level II, modifiers, E/M documentation guidelines, and CMS claims-processing rules
  • Ability to create clear, unambiguous evaluation criteria that reviewers can apply consistently
  • Working knowledge of inter-rater agreement, sampling methods, and distinguishing reviewer error from unclear guidance
  • Ability to explain coding decisions to engineers and product managers and translate technical questions into coding terminology
  • Sound judgment when documentation is incomplete or coding guidance is unclear
  • Demonstrated ability to lead distributed teams across locations or time zones
  • Ability to work independently with limited supervision
  • Working knowledge of HIPAA privacy and security requirements for clinical and de-identified data
  • Availability for periodic overlap with United States time zones
  • Willingness to travel up to 10%

लाभ

  • Quarterly company-wide recharge days
  • Flexible hybrid work environment
  • Peer-nominated “Cheer” incentive awards
  • Tuition reimbursement program

संबंधित नौकरियाँ

Palo Alto Networks

District Sales Manager, Workforce and Agentic Identity — South Africa

Palo Alto Networks

Lead Palo Alto Networks’ Idira Workforce and Agentic Identity sales across Sub-Saharan Africa, guiding overlay specialists and regional partners. Drive go-to-market execution and portfolio growth across the territory.

खोलें
Vertice

APAC Account Executive at Vertice

Vertice
201 – 500 कर्मचारी
विपणन

Win new business across APAC for Vertice’s intelligent procurement platform by closing mid-market SaaS deals. The role also covers revenue forecasting and close collaboration with sales and business development teams.

खोलें
AudioCodes

Enterprise Sales Manager, UC, CC and Voice AI

AudioCodes

Lead UC, CC, and Voice AI sales for AudioCodes in India, building qualified pipeline and closing enterprise opportunities across West India.

खोलें
Mimi Ruth Coaching

Remote Sales Representative, Fitness Coaching

Mimi Ruth Coaching

Help entrepreneurs and executives pursue sustainable weight loss through Mimi Ruth’s premium coaching program. The role covers customer consultations, lead outreach and appointment preparation from a home office.

खोलें
Palo Alto Networks

Commercial Identity Account Manager, Germany

Palo Alto Networks

Lead full-cycle sales of Palo Alto Networks’ IDIRA identity security platform in Germany’s commercial market. Work with customers, channel partners, and the core sales team to grow adoption.

खोलें
Agilent Technologies

Healthcare Diagnostics Sales Account Manager, Sicily

Agilent Technologies

Grow Agilent’s pathology and molecular diagnostics business across Sicily by managing healthcare accounts, strategic customer relationships, and regional sales development.

खोलें
Reaktor

Head of Business HR

Reaktor

Lead Reaktor’s People Partner team and shape HR strategy across its software product and technology consulting businesses. Develop product workforce plans, people practices and leadership capability.

खोलें
Advocate Aurora Health
Nasstar

People and Culture Partner

Nasstar

Partner with managers across the UK employee lifecycle at Nasstar, a digital technology company. Advise on employee relations, organisational change, workforce planning and management development in a remote role.

खोलें
TechnipFMC

HR Specialist, Dhahran

TechnipFMC

Manage payroll, employee records, onboarding, leave and benefits for TechnipFMC’s energy business. Support the OneERP HR transformation through user testing, data quality checks and process improvements.

खोलें