Subject Matter Expert – Surgery Coding
Requisition Number: 2324244
Location: Noida, Uttar Pradesh, India
Category: Medical & Clinical Operations
✅ Role Overview
Optum, a global healthcare organization, is seeking a Subject Matter Expert (SME) – Surgery Coding to support accuracy, compliance, and continuous improvement in surgical medical coding. The role involves training coders, conducting audits, resolving complex cases, and staying updated with US coding guidelines.
✅ Primary Responsibilities
1. Training & Knowledge Enhancement
Develop and deliver training sessions on Surgery Coding, including CPT, ICD-10-CM, HCPCS, and NCCI edits.
Update coders with latest CMS, AMA, and AHA guidelines.
Provide documentation improvement education and coding clarifications.
2. Quality & Performance Management
Conduct audits, quality reviews, and prepare detailed performance reports.
Track assessment scores, audit outcomes, and maintain accurate records.
Participate in coding calibrations and team discussions.
3. Coding Support & Issue Resolution
Assist coders with complex cases and resolve documentation or coding-related queries.
Identify coding gaps and support continuous process improvement.
Collaborate with compliance, QA, and operations teams.
4. Compliance & Organizational Responsibilities
Adhere to all company policies, operational guidelines, and workplace protocols.
Be flexible for role changes, team transfers, shift adjustments, or business-driven updates.
✅ Required Qualifications
Bachelor’s degree in Health Information Management, Life Sciences, or related field (preferred).
AAPC or AHIMA Certification (Mandatory): CPC, CIC, CCS, or COC.
5+ years of experience in medical coding with strong expertise in Surgery Coding.
Strong understanding of:
Surgery coding rules and E/M updates
CMS documentation standards
US Healthcare RCM (Revenue Cycle Management)
EMR/EHR platforms such as EPIC, Cerner, 3M, eCAC
✅ Skills & Competencies
Strong knowledge of medical terminology, anatomy, and physiology.
Proficiency in coding software and EHR systems.
Excellent attention to detail and accuracy.
Strong communication, presentation, and analytical skills.
✅ About UnitedHealth Group
UHG aims to improve global health outcomes by leveraging technology, inclusive culture, and equitable healthcare delivery. The organization is committed to reducing disparities and enabling healthier lives for all communities.
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