Subject Matter Expert – ED/E/M Coding | Optum Hyderabad, Telangana
Job Description
Summary
Optum is looking for a highly skilled Subject Matter Expert (SME) in Emergency Department (ED) and Evaluation & Management (E/M) Outpatient/Inpatient (OP/IP) coding in Hyderabad, Telangana. This role ensures accurate medical coding, regulatory compliance, and process improvement across healthcare operations. The ideal candidate will have deep expertise in CPT, ICD-10-CM, HCPCS coding standards, and experience with coding audits, EMR systems, and revenue cycle optimization. Join Optum to enhance coding quality, support clinical teams, and contribute to high-impact healthcare solutions.
Job Details at a Glance
| Job Title | Subject Matter Expert – ED/E/M Coding |
|---|---|
| Company | Optum (UnitedHealth Group) |
| Location | Hyderabad, Telangana, India |
| Job Category | Medical & Clinical Operations |
| Requisition Number | 2305985 |
| Experience Required | 5+ years in ED/E/M medical coding |
| Education / Certification | CPC, CCS, or equivalent |
| Work Mode | Full-Time / Onsite |
| Shift | Day Job |
Primary Responsibilities
- Conduct high-level coding reviews for ED and E/M OP/IP encounters.
- Assign CPT, ICD-10-CM, and HCPCS codes accurately based on documentation.
- Validate code selection against payer-specific guidelines and NCCI edits.
- Analyze trends in coding accuracy and provide actionable feedback.
- Participate in internal and external coding audits.
- Collaborate with compliance teams to implement corrective actions.
- Stay updated on regulatory changes (CMS, AMA, etc.) and ensure coding adherence.
- Support cross-functional workflow optimization and system enhancement initiatives.
- Address client queries and escalations regarding ED and E/M coding processes.
Required Skills & Qualifications
- Certification: CPC, CCS, or equivalent.
- 5+ years of experience in medical coding, specializing in ED and E/M OP/IP coding.
- Proficiency with EMR and coding platforms such as Epic or Cerner.
- Strong understanding of CPT, ICD-10-CM, HCPCS, CMS, and AMA coding guidelines.
- Excellent analytical, communication, and problem-solving skills.
- Ability to collaborate effectively across clinical and operational teams.
Preferred Skills
- Knowledge of audit processes, compliance standards, and workflow optimization.
- Proficiency in Excel, SQL, or coding analytics tools for reporting and trend analysis.
- Strong understanding of medical billing, documentation quality, and coding compliance.
Why Join Optum
- Contribute to high-quality healthcare operations and revenue cycle management.
- Work with cross-functional teams in a collaborative, inclusive environment.
- Leverage your expertise to train, mentor, and improve coding accuracy across the organization.
- Participate in continuous improvement initiatives that directly impact patient care and provider operations.
Apply Now
Start your career as a Subject Matter Expert – ED/E/M Coding at Optum Hyderabad.