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Veradigm®
Veradigm®
1.001 – 5.000 Angajați
Asigurare de sănătateAsistență medicalăSaaS
Veradigm® dezvoltă tehnologii medicale bazate pe cloud pentru furnizori de servicii medicale, plătitori și organizații din domeniul științelor vieții. Platforma sa conectată reunește software clinic și financiar, inclusiv dosare electronice de sănătate, gestionarea cabinetelor, servicii pentru ciclul veniturilor, prescriere electronică, schimb de date, API-uri, soluții de analiză, instrumente pentru date și dovezi din lumea reală, soluții pentru calitate și ajustarea riscurilor, precum și funcții de implicare a pacienților. Prin intermediul Veradigm Network, aceste produse sprijină furnizarea îngrijirii, operațiunile din domeniul sănătății și cercetarea în întregul ecosistem medical.
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Locurile de muncă ale companiei

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.

INIndiaHibridNormă întreagăNivel mediuSeniorLimbă Obligatorie: englezăFacturare și codificare medicală

Descriere

  • 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

Cerințe

  • 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%

Beneficii

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

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