Subject Matter Expert

3 days ago

Noida, Uttar Pradesh, India Optum Full time ₹ 12,00,000 - ₹ 24,00,000 per year

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.

Primary Responsibilities:

  • Design and deliver accuracy, knowledge update for coding professionals on Surgery coding practices, covering CPT, ICD-10-CM, HCPCS, NCCI edits
  • Keep up to date with changes in coding guidelines (CMS, AMA, AHA coding clinics) and integrate them into team communication
  • Prepare accurate reports, maintain accurate records
  • Responsible for tracking assessment scores, coding performance through audits, quality reviews, providing detailed feedback and guidance
  • Participate in coding calibration meetings and contribute to coding related discussions
  • Support coders with complex case resolution, documentation improvement education, and coding clarification
  • Collaborate with the compliance, QA and operations teams to identify coding gaps and ensure continuous improvement
  • Comply with the terms and conditions of the employment contract, company policies and procedures, and any and all directives (such as, but not limited to, transfer and/or re-assignment to different work locations, change in teams and/or work shifts, policies in regard to flexibility of work benefits and/or work environment, alternative work arrangements, and other decisions that may arise due to the changing business environment). The Company may adopt, vary or rescind these policies and directives in its absolute discretion and without any limitation (implied or otherwise) on its ability to do so

Required Qualifications:

  • Bachelor's degree in health information management, life science or a related field is preferred
  • AAPC/AHIMA Certification is required: CPC, CIC, CCS, COC

    5+ years of experience in medical coding, with specialization in Surgery coding

    In-depth understanding of Surgery and E/M guideline changes and CMS documentation
  • Solid Knowledge of US healthcare RCM system
  • Familiarity with EMR/EHR, compliance standards, auditing platforms
  • Proven excellent attention to detail and accuracy in coding and documentation
  • Proficiency in coding software and EHR systems (EPIC. eCAC, 3M, Cerner etc.)
  • Skills
  • Solid understanding of medical terminology, anatomy, and physiology
  • Proven excellent communication and presentation skills

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone - of every race, gender, sexuality, age, location and income - deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.

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