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2 Optum Cac Jobs

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1.0 - 6.0 years

3 - 6 Lacs

Hyderabad, Telangana, India

On-site

Key Responsibilities: Review radiology reports and assign appropriate CPT, ICD-10-CM, and HCPCS codes Code for a variety of radiology services including: Diagnostic Radiology X-ray, MRI, CT, Ultrasound Interventional Radiology Angiography, Biopsies, Drainage, etc. Apply appropriate modifiers and code combinations based on NCCI edits and payer rules Maintain coding productivity and accuracy as per SLAs Collaborate with QA teams to respond to audits or physician queries Stay updated on AAPC/AHIMA, CMS , and payer-specific coding guidelines Qualifications: Education: Graduate in Life Sciences / Paramedical / Allied Health Certifications: CPC, COC, or CCS (Mandatory) Experience: Minimum 1 year of hands-on experience in Radiology coding Experience in interventional procedures is a plus Familiarity with EMRs like Epic, Cerner, Athena, or eClinicalWorks preferred Key Skills Required: Strong understanding of radiology anatomy, procedures, and terminology Proficient in ICD-10-CM, CPT , and modifier usage Working knowledge of encoder tools like 3M, TruCode, or Optum Encoder Knowledge of billing guidelines, payer policies , and compliance standards

Posted 1 week ago

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1.0 - 6.0 years

3 - 6 Lacs

Hyderabad, Telangana, India

On-site

Key Responsibilities: Surgery Coding: Assign accurate ICD-10-CM and CPT codes for multi-specialty surgical procedures Apply modifiers , ensure correct sequencing, and adhere to NCCI edits Review operative reports and apply appropriate global periods and surgical packages Ensure coding is compliant with CMS, AHA Coding Clinic , and client policies IPDRG Coding: Review inpatient medical records , assign ICD-10-CM & ICD-10-PCS codes Assign MS-DRGs or APR-DRGs using encoder tools Validate principal diagnosis, secondary conditions, POA indicators, and procedures Ensure documentation supports the assigned DRG and meets coding guidelines Qualifications: Education: Degree in Life Sciences / Paramedical / Nursing / Allied Health Certifications: CPC, CCS, CIC (AHIMA or AAPC) Mandatory Experience: 26 years in Surgical and/or Inpatient DRG coding Experience with 3M Encoder, Optum CAC, EPIC, Cerner (preferred) Skills Required: Expert in ICD-10-CM, ICD-10-PCS, CPT, and HCPCS Strong knowledge of DRG grouping methodologies (MS-DRG/APR-DRG) Familiarity with coding guidelines, MCE edits, and query processes Attention to detail and ability to handle complex cases with minimal supervision Strong analytical, communication, and documentation skills

Posted 1 week ago

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