Senior Medical Coder – IPDRG
Location: India
Company: Optum
Employment Type: Full-Time
Role Summary
The Senior Medical Coder – IPDRG is responsible for accurate medical coding and abstraction of diagnoses, procedures, and modifiers from patient medical records across multiple healthcare settings. The role involves assigning ICD-10-CM, CPT, and HCPCS Level II codes while ensuring compliance with coding guidelines, regulatory requirements, and client-specific standards.
This position requires strong expertise in Evaluation & Management (E&M) coding, multispecialty coding, medical terminology, anatomy, physiology, and healthcare reimbursement regulations. The Senior Medical Coder plays a critical role in ensuring coding accuracy, productivity, compliance, and revenue cycle integrity.
Key Responsibilities
Medical Coding & Documentation Review
Review and analyze medical records from:
Multispecialty Outpatient Clinics
Urgent Care Centers
Inpatient Hospital Settings
Abstract relevant clinical information from patient records.
Assign accurate:
ICD-10-CM Diagnosis Codes
CPT Procedure Codes
HCPCS Level II Codes
Appropriate Modifiers
Ensure coding aligns with clinical documentation and regulatory standards.
Evaluation & Management (E&M) Coding
Determine appropriate E&M levels for outpatient visits using:
Medical Decision Making (MDM)
Documentation Guidelines
Assign E&M codes including:
99202 – 99215
Apply coding guidelines accurately to support compliant billing and reimbursement.
Review provider documentation to ensure coding completeness and accuracy.
Specialty Coding Support
Perform coding for various specialties including:
Internal Medicine
Family Medicine
Urgent Care
Dermatology
Gastroenterology
Cardiology
Otolaryngology (ENT)
Review documentation and assign procedure-specific CPT codes.
Support coding of specialty-specific services and procedures.
Procedure & Ancillary Coding
Review and code:
Minor Surgical Procedures
Vaccinations
Laboratory Services
Screening Procedures
Preventive Care Services
Extract and assign:
Screening CPT Codes
PQRS Codes
Quality Reporting Codes
Ensure coding reflects services documented in the medical record.
Coding Compliance & Regulatory Adherence
Ensure compliance with:
ICD-10-CM Official Coding Guidelines
CPT Coding Guidelines
HCPCS Level II Guidelines
CMS Regulations
Coding Clinic Guidance
Client-Specific Coding Policies
Stay updated with:
AMA Updates
AHA Coding Guidance
CMS Regulatory Changes
Implement coding changes and updates as required.
Coding Quality & Productivity
Maintain productivity target of:
12 Charts Per Hour
Consistently meet quality and accuracy benchmarks.
Participate in coding audits and quality improvement initiatives.
Resolve coding edits and discrepancies within required timelines.
Contribute to continuous improvement of coding processes.
NCCI & Coverage Determination Review
Review and apply:
National Correct Coding Initiative (NCCI) Edits
Local Coverage Determinations (LCDs)
National Coverage Determinations (NCDs)
Modify:
ICD-10-CM Codes
CPT Codes
Modifiers
as required to ensure compliance and reimbursement accuracy.
Identify and resolve coding conflicts and denials proactively.
Data Privacy & Compliance
Ensure compliance with:
HIPAA Regulations
Patient Confidentiality Requirements
Information Security Policies
Maintain confidentiality of patient records and protected health information (PHI).
Demonstrate understanding of system security requirements and data protection standards.
Follow all company compliance and ethical guidelines.
Team Collaboration & Knowledge Sharing
Collaborate with coding teams and operational stakeholders.
Share coding updates, best practices, and process improvements.
Support team quality and productivity initiatives.
Contribute positively to team performance and knowledge development.
Required Qualifications
Education
One of the following qualifications:
Bachelor's Degree in:
Life Sciences
Allied Health Sciences
Nursing
Pharmacy
Biotechnology
Related Healthcare Discipline
Certification (Mandatory)
One of the following:
Certified Professional Coder (CPC) – AAPC
Certified Coding Specialist (CCS) – AHIMA
Equivalent Medical Coding Certification
Experience
Relevant experience in:
Medical Coding
E&M Coding
Multispecialty Coding
Outpatient Coding
Professional Fee Coding
Experience coding across multiple specialties and healthcare settings.
Experience working with ICD-10-CM, CPT, and HCPCS coding systems.
Uttar Pradesh :
Agra | Gajraula | Gautam buddha Nagar | Ghaziabad | Gorakhpur | Greater Noida | Jhansi | kanpur | Lucknow | Mathura | Noida | Park City | Prayagraj | Satyamev | Varanasi |Gujarat :
Ahmedabad | Ankleshwar | Baroda | Bharuch | Gandhinagar | Gujarat | Halol | Jhagadia | Mehsana | surat | Tarasadi | Vadodara | Vapi |Maharashtra :
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Ambala | Gurugram | Haryana | Hisar | Kurukshetra | Panchkula | Rohtak | Shivalik |Punjab :
amritsar | Bathinda | Bela | Chandigarh | ludhiana | Moga | Mohali | Patiala | Phagwara | Punjab | Rajpura |Andra Pradesh :
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Annamalainagar | Chennai | Coimbatore | Erode | Madurai | Nagercoil | Ooty | Pudupakkam | Srivilliputtur | Tamil nadu | Tiruchirappalli | tiruppur | Trichy | Vellore | Yogyakarta |Himachal Pradesh :
Baddi | Solan |Rajasthan :
Banasthali | Bhiwadi | Jaipur | Pilani | Udaipur |Karnataka :
Bangalore | Belgaum | Bengaluru | B.G Nagara | Bommasandra | Colorado | Czech Republic | Karnataka | Mangaluru | Mysore | Udupi |Madhya Pradesh :
Bhopal | Dewas | Gwalior | Indore | Khandwa | Khargone | Pithampur | Ujjain |Odisha :
Bhubaneswar | Rourkela |Chhattisgarh :
Bilaspur | Eot Municipality | Raipur |Uttarakhand :
Dehradun | Halifax | Nainital | Rishikesh | Roorkee |Delhi :
Delhi | Gangtok | New Delhi | PAN-India |Assam :
Dibrugarh | Diburghar | Guwahati |West Bengal :
Digha | Kolkata | Mukundapur |Goa :
Goa | Panaji | Verna |Bihar :
Hajipur | Patna |Kerala :
Kannur | Kochi | Malappuram | Thiruvananthapuram | Trivandrum |Pondicherry (Puducherry) :
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Ranchi |Sikkim :
Rangpo |India :
Remote, India | Siliguri |Illinois :
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Anchorage | Barrow | Bethel | Juneau | Sitka | Wrangell |Massachusetts :
Andover | Billerica | Boston | Cambridge | Devens | Lexington | Massachusetts | Medford and Somerville | Rockland |Wisconsin :
Appleton | Kenosha | Pleasant Prairie | Portage | Waukesha |United states :
Arizona | Buffalo Grove | Clayton | Downers Grove | fairmont | Geelong Vic | Georgia | Keene | Michigan | Mt. Pleasant | New Jersy | OH | Piedmont | Salisbury | Whitesboro | Winston-Salem |Georgia :
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Birmingham |Virginia :
Blacksburg | Charlottesville | Falls Church | Mechanicsville |Indiana :
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Boise |Colorado :
Boulder | Denver | Westminster |Connecticut :
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Chandler | Kingman | Lake Havasu City | Mesa | Peridot | Phoenix | Surprise | Tempe | Tucson | Yuma |South Carolina :
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Chengdu | Garden city | Kansas City | Lawrence | McPherson |North Carolina :
Concord | Lumberton | North Carolina |Michigan :
Detroit | Houghton Lake | Macomb | Southfield |North Dakota :
Dickinson |Minnesota :
Duluth | Eden Prairie | Fridley | Hibbing | Maple Grove | Minneapolis and St. Paul, Minnesota. | Minnetonka | St.Paul |Kentucky :
Edgewood | Ft MItchell | Louisville | Shelbyville |Arkansas :
Fort Smith |Kington :
Frank Scottile Blvd |Missouri :
Fulton | Milan | St. Louis |United States :
Hawai | kentucky | Sylmar | Woonsocket |Nebraska :
Hebron | Nebraska City |Hawaii :
Hilo | Honolulu |Tennessee :
Knoxville | Memphis | Nashville |Louisiana :
Lake Charles | Shreveport |Nevada :
Las Vegas | Tonopah | Tonopsh | Virginia |New Hampshire :
Lebanon | Macon | Manchester |Portugal :
Lisbon | Oeiras | Portugal |WI :
Madison | Wausau |Republic of Mexico :
Mexico |northeastern :
New Hampshire |Oklahoma :
Oklahoma City |Puerto Rico :
San Juan |Albama :
Tuscaloosa |D.C :
Washington |Delaware :
Wilmington |North Rhine Westphalia :
Aachen | Bielefeld | Bochum | Bonn | Cologne | Dortmund | Duisburg | Dusseldorf | Munster |Munich :
Bavaria |Bavaria :
Bayreuth | Erlangen | Munich | Regensburg | Wurzburg |Brandenburg :
Berlin |Baden-Wurttemberg :
Biberach an der Riß | Freiburg | Grenzach | Heidelberg | Karlsruhe | Konstanz | Stuttgart | Tubingen | Ulm |Hesse :
Darmstadt | Marburg |Hessen :
Frankfurt | Harveysburg |Germany :
Germany | GErmany |Lower Saxony :
Gottingen | Hannover | Leipzig |Saxony Anhalt :
Halle |Rotherbaum :
Hamburg |Rhineland Palatinate :
Ingelheim am Rhein | Mainz |Schleswig Holstein :
Kiel |Berlin :
Mitte |Mecklenburg Vorpommern :
Rostock |Saarland :
Saarbrucken |Switzerland :
Basel | Zurich |Serbia :
Belgrade | Serbia |Hungary :
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Bulgaria | Vedant |Denmark :
Copenhagen | Denmark |Europe :
Europe | France | Latvia | Lendava | Leuven | Poland | Slovenia | Spain |Finland :
Finland |Istanbul :
Istanbul | Turkey |Norway :
Norway | NOrway |Romania :
Romania |Belgium :
Wavre |Tipperary :
Ballydine |Cork :
Brinny | Ringaskiddy |Carlow :
Carlow |Republic of Ireland :
Cork | Dublin | Limerick | Waterford |Ulster :
Donegal |Meath :
Dunboyne |Dún Laoghaire :
Dún Laoghaire |Galway :
Galway |County Dublin :
Swords |Republic of China :
Beijing |China :
China | Quarry Bay |Liaoning :
Dalian |Zhejiang :
Hangzhou |Tokiyo :
Osaka | Tokyo |Shanghai Sai :
Shanghai Shi |Hubei :
Wuhan |Capital of Netherland :
Amsterdam |North Brabant :
Breda |Noord Holland :
Haarlem |South Holland :
Leiden |Netherlands :
Netherlands |Remote Australia :
Arkansas | Remote Australia |New South Wales :
Ballina | Sydney |Republic of Western Australia :
Nedlands |Queensland :
Queensland |Melbourne :
South Yarra |United Kingdom :
England | Harlow | Leeds | London | Maidenhead | Salt Lake City | Stevenage | Stirling | United Kingdom |North Yorkshire :
Harrogate |South Yorkshire :
Sheffield |Oxfordshire :
Witney |Ontario :
Renfrew | Mississauga | Richmond Hill | Australia | North York | Uxbridge |Canada :
Canada |Quebec :
Montreal |Brussels :
Brussels |Antwerp :
Heist op den Berg |Flemish Brabant :
Zaventem |South America :
Argentina | Peru |Brazil :
Brazil | Sao paulo |Attica :
Koropi | Athens |Greece :
Greece |North Island :
Auckland |New Zealand :
New Zealand |Austria :
Austria |Vienna :
Vienna |Catalonia :
Barcelona |Madrid :
Madrid |Cebu Province :
Cebu City |Philippines :
Manila |Croatia :
Croatia |Zagreb :
Zagreb |Estonia :
Estonia | Tartu |Harju County (Maakond) :
Tallinn |Hà Nội :
Hà Nội | Hanoi |Ho Chi Minh :
Ho Chi Minh City |Italy :
Italy |Lombardy :
Rho |Jakarta :
Jakarta |East Java :
Surabaya |Japan :
Saitama | Japan |Tokyo :
Otemachi |North Ostrobothnia :
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Switzerland | Melbourne | Remote - South America (Latin Americal) | Texas | Tulsa | Zaragoza | Lousiana | Bishop | Victoria | Hammond | Slovakia | Minnesota | Riga | Xzagreb | Remote - Africa | Faridabad | Green Way | Remote - Europe | Nairobi | Regulatory Labeling Manager (NA and LATAM Only) | Manipal | Remote - Middle East | McFarland | Blue Bell | Ireland | Thailand | Bountiful | Belgium | French | Leinster | Milwaukee | Medan | Perth | Springville | Castlebar | Lenexa | Hungary |Republic of Colombia :
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Kyiv |Lima Region :
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South Africa | Midrand |Nišava District :
Niš |Bohemia :
Prague |Chile :
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Warsaw |
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