Subject Matter Expert – Surgery Coding
Location: Noida, Uttar Pradesh, India
Job Category: Medical & Clinical Operations
Requisition Number: 2324244
Experience Required: Minimum 5 years of medical coding experience with specialization in Surgery Coding
Employment Type: Full-Time
About the Role
Optum, a global leader in technology-enabled healthcare, is seeking an experienced Subject Matter Expert (SME) – Surgery Coding to support coding accuracy, guideline updates, quality improvement, and coder development across surgery coding functions. This role is essential in maintaining compliance, strengthening coding capabilities, and ensuring high-quality documentation within the healthcare revenue cycle.
As part of Optum’s expert coding team, you will provide advanced training, coding clarification, audit support, and guidance on surgery-specific coding scenarios to enhance operational performance and coding excellence.
Key Responsibilities
Training, Coaching & Knowledge Enhancement
Develop and deliver training programs for coding professionals focused on Surgery coding, including CPT, ICD-10-CM, HCPCS, and NCCI guidelines.
Stay current with coding updates from CMS, AMA, AHA Coding Clinics, and communicate changes to the team.
Provide guidance on documentation improvement and complex coding scenarios.
Quality, Compliance & Audit Support
Track coder assessment scores, audit results, and overall coding performance.
Conduct quality reviews, offer detailed feedback, and ensure consistent accuracy in coding submissions.
Participate in coding calibration meetings and contribute expert insights.
Work closely with compliance, QA, and operations teams to identify gaps and support continuous improvement.
Operational Coordination & Reporting
Prepare accurate reports and maintain detailed records related to training, audits, and coding updates.
Support coders with coding clarifications, documentation interpretations, and case-specific guidance.
Ensure adherence to company policies, work location requirements, shift flexibility, and operational changes as required.
Required Qualifications
Education
Bachelor’s degree in Health Information Management, Life Sciences, or a related field (preferred).
Certifications
Valid AAPC or AHIMA certification is mandatory:
CPC
CIC
CCS
COC
Experience
Minimum 5+ years of proven medical coding experience, with strong expertise in Surgery Coding.
In-depth knowledge of Surgery and Evaluation & Management (E/M) guideline updates.
Strong understanding of US Healthcare Revenue Cycle Management (RCM).
Experience using EMR/EHR systems and auditing platforms such as EPIC, eCAC, 3M, and Cerner.
Skills & Competencies
Comprehensive understanding of medical terminology, anatomy, and physiology.
Strong accuracy, attention to detail, and documentation review skills.
Excellent communication and presentation skills.
Ability to support teams in complex case resolution and guideline clarification.
Why This Role Is Important
This role is essential for ensuring coding accuracy, maintaining compliance with evolving regulatory requirements, and elevating coding performance across surgery-related healthcare documentation. It provides an opportunity to influence process improvements and support large-scale healthcare operations within a globally recognized organization.
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