Subject Matter Expert – Surgery Coding
Requisition Number: 2324244
Job Category: Medical & Clinical Operations
Primary Location: Noida, Uttar Pradesh, India
About Optum
Optum is a global healthcare organization that leverages advanced technology to deliver better care and improve health outcomes for millions worldwide. The company’s inclusive culture, talented peers, and career development opportunities empower employees to make a lasting impact on communities and healthcare systems.
Join us to Care. Connect. Grow together.
Position Summary
The Subject Matter Expert (SME) – Surgery Coding is responsible for developing and delivering training, performance improvement, and quality initiatives related to surgery coding. This role ensures coders are well-versed in current CPT, ICD-10-CM, and HCPCS standards while maintaining compliance with CMS, AMA, and AHA guidelines.
Primary Responsibilities
Design and deliver training sessions and knowledge updates on surgery coding practices, covering CPT, ICD-10-CM, HCPCS, and NCCI edits.
Stay current with CMS, AMA, and AHA coding clinic updates and communicate changes to the team.
Prepare and maintain accurate reports and records for audits, training, and performance tracking.
Track coder assessment scores and quality metrics, providing detailed feedback and coaching.
Participate in coding calibration meetings and contribute to discussions on complex coding scenarios.
Support coders in complex case resolution, documentation improvement, and clarification of coding guidelines.
Collaborate with Compliance, Quality Assurance, and Operations teams to identify gaps and drive continuous improvement.
Adhere to company policies and directives, including potential reassignments or workflow changes as business needs evolve.
Required Qualifications
Education:
Bachelor’s degree in Health Information Management, Life Sciences, or a related field (preferred).
Certifications:
Active AAPC/AHIMA certification required — accepted credentials: CPC, CIC, CCS, or COC.
Experience:
Minimum 5+ years of experience in medical coding, specializing in surgery coding.
Technical Expertise:
Strong understanding of E/M guidelines, CMS documentation, and U.S. healthcare RCM systems.
Experience using EMR/EHR and coding/auditing platforms (e.g., Epic, 3M, Cerner, eCAC).
Skills & Knowledge:
In-depth knowledge of medical terminology, anatomy, and physiology.
Excellent communication, presentation, and documentation skills.
High attention to detail and accuracy in coding and reporting.
Additional Details
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Detail |
Information |
|---|---|
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Business Segment |
Optum |
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Employee Status |
Regular |
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Work Schedule |
Full-time, Day Job |
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Overtime Status |
Exempt |
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Travel Requirement |
No |
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Telecommuter Position |
No |
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Country |
India |
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