SME – Medical Coding
Location: Chennai, Tamil Nadu, India
Job Category: Medical & Clinical Operations
Requisition Number: 2292915
Estimated Salary: ₹8.5 LPA – ₹12.5 LPA (based on experience and industry standards for SME roles in Chennai)
About the Role:
Optum is hiring a Subject Matter Expert (SME) – Medical Coding with specialized expertise in Acute Care Inpatient Coding. This role requires deep knowledge of complex medical cases, accurate ICD-10-CM & PCS coding, and a strong understanding of DRG classifications. You will work closely with medical documentation and coding teams to ensure quality, compliance, and efficient coding practices in a fast-paced healthcare setting.
Primary Responsibilities:
Assign appropriate ICD-10-CM and ICD-10-PCS codes for inpatient hospital services.
Evaluate coding impact on DRGs, including CC/MCC factors, per official guidelines.
Abstract required data elements during chart reviews.
Ensure coding adheres to ethical standards as per AAPC/AHIMA norms.
Maintain productivity of 1.5–2.5 inpatient charts per hour while upholding accuracy standards.
Monitor and apply AHA guideline updates promptly.
Query physicians and provide documentation feedback when necessary.
Review coding materials shared by managers and participate in internal audits and trainings.
Track and maintain logs of coded, held, or missing charts.
Collaborate within a team to enhance coding quality and output.
Adhere to HIPAA and internal confidentiality/security policies.
Follow organizational policies on work shifts, team changes, and location transfers as required by evolving business needs.
Required Qualifications:
Graduate in Life Sciences or Allied Medical disciplines.
Certified coder via AAPC or AHIMA (CIC certification preferred).
Minimum 5 years of experience in Acute Care Inpatient medical coding.
Experience in Level I trauma centers or teaching hospitals.
Hands-on expertise with:
Major trauma ER cases
Cardiac catheterization
Interventional radiology
Orthopedic and neurology coding
Observation coding
Strong knowledge of ICD-10 (CM & PCS) and DRG methodologies.
Why Join Optum?
At Optum, you become part of a purpose-driven team working to enhance health systems around the world. With an inclusive culture, career advancement opportunities, and access to the latest in medical coding best practices, this role lets you grow while making a real impact on health outcomes.
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