SME – Medical Coding
Location: Chennai, Tamil Nadu, India
Job Category: Medical & Clinical Operations
Requisition Number: 2292915
Estimated Salary: ₹8.5 LPA – ₹12 LPA (based on role seniority and Chennai market standards)
About the Role:
As a Subject Matter Expert (SME) in Medical Coding at Optum, you will apply expert-level knowledge of inpatient coding practices, complex procedures, and DRG assignments. You will play a key role in maintaining coding accuracy, training peers, and optimizing coding quality while staying aligned with compliance and regulatory guidelines.
Primary Responsibilities:
Assign accurate ICD-10-CM and ICD-10-PCS codes for inpatient hospital services.
Assess coding impact on DRG classifications, including CC/MCC considerations.
Abstract relevant data during chart review, supporting medical necessity and coding precision.
Track and implement all AHA guideline updates regularly.
Maintain ethical coding standards in line with AAPC and AHIMA codes of conduct.
Achieve coding productivity of 1.5–2.5 charts per hour while meeting quality benchmarks.
Offer constructive documentation feedback and raise physician queries where necessary.
Maintain updated knowledge via materials shared by coding quality managers and directors.
Participate in coding team meetings, educational events, and audits.
Record and track coded, held, or missing charts.
Uphold HIPAA compliance and system data security standards.
Required Qualifications:
Graduate in Life Sciences or Allied Medicine.
Certified medical coder via AAPC or AHIMA (CIC preferred).
Minimum 5+ years of Acute Care Inpatient medical coding experience.
Experience coding for Level I trauma centers or teaching hospitals.
Proficiency in coding complex procedures such as:
Major trauma ER
Cardiac catheterization
Interventional radiology
Orthopedic & neurology surgeries
Observation coding
In-depth expertise in ICD-10 (CM & PCS) and DRG systems.
Why Join Optum?
Optum is a global leader at the intersection of healthcare, technology, and data. Here, you’ll be part of a passionate and collaborative team working to remove barriers in healthcare access. We foster a culture of continuous learning, inclusion, and advancement—all aligned with the mission to make the healthcare system work better for everyone.
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