SME – Medical Coding (Acute Care Inpatient)
Location: Noida, Uttar Pradesh, India
Company: Optum (UnitedHealth Group)
Function: Medical & Clinical Operations
Work Mode: Not specified (assume On‑site/Hybrid)
Compensation / Salary Range: Not disclosed in the job description.
Job Summary
Optum is seeking an experienced Subject Matter Expert (SME) – Medical Coding to lead high‑complexity acute care inpatient coding using ICD‑10‑CM/PCS and DRG methodologies. The ideal candidate (CIC preferred) brings 5+ years of hospital/facility coding experience, including exposure to Level I trauma centers, complex procedures (cardiac cath, IR, ortho, neuro), and strict adherence to AAPC/AHIMA coding ethics and HIPAA compliance. You will mentor teams, drive quality and productivity, and stay current with AHA Coding Clinic updates.
Key Responsibilities
Assign accurate ICD‑10‑CM/PCS and DRG codes for inpatient encounters, ensuring CC/MCC capture and compliance with official/corporate guidelines.
Achieve and maintain ≥95% coding accuracy and productivity targets (1.5–2.5 charts/hour).
Abstract additional clinical data elements during chart review.
Continuously implement AHA guideline updates and provide documentation feedback/queries to physicians.
Track coded/held/missing charts and resolve edits within regulatory/client timelines.
Participate in coding meetings, audits, and ongoing education to sustain high quality.
Safeguard patient data per HIPAA and internal security policies.
Act as a team player and contribute to continuous improvement in quality and throughput.
Required Skills & Qualifications
Education: Life Science or Allied Medicine graduates.
Certifications: AAPC or AHIMA certification (CIC preferred; CPC/CCS/COC also accepted).
Experience: 5+ years of acute care inpatient medical coding (hospital/facility).
Proven expertise coding complex cases from Level I trauma centers / teaching hospitals (major trauma ER, cardiac catheterization, interventional radiology, orthopedic, neurology, observation).
Strong command of ICD‑10‑CM, ICD‑10‑PCS, DRG assignment and sequencing rules.
Deep knowledge of AAPC/AHIMA ethical standards, HIPAA, and payer/reimbursement impacts.
Excellent analytical, documentation, and communication skills.
Perks & Benefits (as typically offered by Optum / UHG)
Inclusive, growth‑focused culture with career development opportunities.
Exposure to complex US healthcare coding environments and enterprise‑grade tools.
Continuous education, audits, and feedback to enhance coding accuracy and compliance.
Comprehensive corporate benefits package (details provided during hiring process).
Company Description
Optum, part of UnitedHealth Group, is a global healthcare leader combining technology, data, and clinical expertise to improve health outcomes. With a strong commitment to equity, inclusion, and sustainability, Optum empowers healthcare professionals to make a measurable impact at scale.
Work Model
Not specified in the job description (likely On‑site/Hybrid in Noida, India).
Apply Now
Ready to lead complex inpatient coding and elevate quality standards at a global healthcare leader? Apply now and join Optum’s Medical Coding team in Noida.
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