Medical Coding - Multispecialty

Company Overview

There is a common misunderstanding around medical coding careers. Many people assume the work is only about looking at patient records and entering codes into software. The reality is more serious than that.

That is where companies like Optum come in.

Optum is a global healthcare organization that operates in the intersection of care delivery, pharmacy benefit solutions, technology, data, and health operations. Optum serves millions of people in providing solutions that help healthcare organizations link patients with care, resources, and services. In addition to health technology and insurance solutions, Optum also offers clinical documentation management, revenue cycle, coding, and health operations management for hospitals and health organizations.

Optum India also endeavors to create career sustainability for its employees when it comes to the aspect of career growth. The company’s culture is all about caring, connections, and growth. Apart from making sure that their employees fulfill certain roles in the company, Optum India makes sure that they grow professionally through meaningful engagements, development of skills, exposure to different healthcare processes, and working in collaboration with various teams.

Apart from creating an internal company culture, Optum India is also known for its contribution to Indian society. It does so by collaborating with NGOs, engaging in volunteering activities, implementing health equity campaigns, building healthcare capacity, and offering training and skill development programs.

Optum India may represent a good starting point in terms of global healthcare operations, health technology, analytics, coding, clinical operations, revenue cycle management, and other corporate healthcare careers. Such an opportunity will be especially beneficial for health graduates and other entry-level professionals in the field.

Job Summary

In this job it's important to have knowledge of medical coding. The other important work will be maintain clinical records and putting the right ICD-10 CM, CPT, HCPCS Level II codes, and modifiers according to the need.

A lot of documents will be easy to maintain but few will require brainstorming and will test your medical coding skills. So, you need to have skills like attention to detail, confidence and time management skills as well.

This job will provide ample experience in the processes related to medical coding.

Key Responsibilities

Thoroughly review medical records before coding

You will be reviewing medical records obtained from Urgent Care Centers and Emergency Department settings, identifying clinical information that needs to be coded properly. While some medical records might be easy to code, other medical records might need to be read carefully to make sure that you understand the diagnosis, procedures, treatments, and other clinical details.

Coding of Medical Records

You will have to apply appropriate codes to the medical records. These codes include ICD-10-CM, CPT, and HCPCS Level II codes and modifiers. Accuracy will play a major role since any errors can result in incorrect reimbursement and reporting.

Be productive and consistent

As you code each of these medical records, you should be able to code around 12 charts per hour and meet the required level of accuracy.

Updates to the Coding Guidelines

You need to keep up-to-date with changes made by AMA, AHA, CMS, CPT, ICD-10-CM, and your clients' guidelines regarding medical codes. These changes should be considered as you code medical records.

Leveling of E/M visits and use of Modifiers

You will determine the level of E/M visits based on medical decision making. You will also use appropriate modifiers for CPT Codes using NCCI and CPT guidelines.

Coding Procedures, Vaccinations, Laboratory Services and Screenings

You will analyze medical documentation and assign and modify CPT codes in relation to minor procedures, vaccinations, laboratory tests, screening procedures, PQRS codes.

Analyze coding edits and coverage policy

You will analyze NCCI coding edits and determine LCD and NCD coverage determination, modify ICD-10-CM, CPT codes and modifiers if needed.

Resolution of coding edits on time

You will prioritize assigned tasks in a way that allows you to code and resolve coding edits in timely manner. This is important from regulatory and client perspective.

Support quality and productivity improvement

You will be working as part of big team and provide inputs and ideas for coding quality, productivity improvement and workflow improvement.

Confidentiality and healthcare data security

Medical coding requires handling confidential patient records. Therefore, you will have to comply with HIPAA privacy policies and keep patient information confidential.

Work according to employer requirements

You will need to adhere to terms of employment, policies and procedures, shift work, reassignment, work relocation and other business related instructions.

Qualifications and Skills

Must-Have Skills

• Bachelor’s degree in Life Sciences or allied medicine

• Certified from either AAPC or AHIMA

• At least 2 years of experience coding for Multispecialty Emergency Department and Surgery practices

• Hands-on experience in coding services for the Emergency Department and Critical Care cases

• Understanding of medical terminology, anatomy, and physiology

• Knowledge of coding rules for ICD-10-CM, CPT, and HCPCS codes

Bonus Skills

• It is a plus point if you have an understanding of multispecialty coding process

• Surgery Coding experience will be an added advantage

• Ability to review complicated ED and Critical Care medical record documents

• Awareness of coding compliance issues, modifiers, and payers’ policies

Soft Skills & Personality Traits

• Pays attention to details

• Patience while reviewing medical records

• Understanding of proper documentation practices

• Meets coding quality and productivity targets

• Faster learner

• Deadlines oriented

• Works well in teams

Salary and Benefits

The Salary offered for this job, depending upon prior experience and other abilities lies between ₹4 LPA to ₹6 LPA. This can be negotiated on the basis of coding proficiency, certification, technical expertise, and the interview performance.

Additional benefits include health insurance coverage, personal and professional development, career development based on performance, and healthcare operations professional.

Career Growth Opportunities

Good opportunities exist in this field if one remains consistent and enhances the level of accuracy in their work. One might reach positions such as a senior medical coder, a coding auditor, quality checker, or a team leader within a few years of experience. One might also progress towards coding trainer, compliance, revenue cycle, or healthcare operations roles.

Team Structure

You will work within a medical coding operations environment alongside other coders, coding auditors, and quality-support colleagues. Most communication will happen within the immediate coding team, team leads, and supervisors. You may also coordinate with compliance, revenue cycle, or client-support teams when coding clarification or edit resolution is needed.

Why This Role Stands Out

This role makes more sense for people who enjoy organised, detail-based healthcare work. Not everyone wants hospital duty. Not everyone wants direct patient care forever either. Medical coding is healthcare-based, analytical, compliance-focused, and useful in the global healthcare industry.

How to Apply

The requirement at Optum is professionals who are capable of applying coding guidelines, being precise and coding for ED, CC, and surgical services.

Before applying for the position advertised, it is recommended to improve your CV with your experience in ED Coding, Surgery Coding, ICD-10-CM, CPT, HCPCS, modifiers, E/M Level, NCCI edits, medical terminologies, anatomy and physiology, as well as AAPC and AHIMA certification.

Your CV needs to indicate your coding precision, productivity, knowledge about compliance, and submission. Once you're done, click the apply button.

All the best!