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Sme- Medical Coding

5+ years
Not Disclosed
10 July 25, 2025
Job Description
Job Type: Full Time Education: B.Sc./M.Sc/B.Pharm/M.Pharm/Life Science Skills: Causality Assessment, Clinical SAS Programming, Communication Skills, CPC Certified, GCP guidelines, ICD-10 CM Codes, CPT-Codes, HCPCS Codes, ICD-10 CM, CPT, HCPCS Coding, ICH guidelines, ICSR Case Processing, Interpersonal Skill, Labelling Assessment, MedDRA Coding, Medical Billing, Medical Coding, Medical Terminology, Narrative Writing, Research & Development, Technical Skill, Triage of ICSRs, WHO DD Coding

 

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.