Surgery - SME/TL

Eclat-Health-Solutions-4; Hyderabad; On-site; INR 1,200,000 - 1,800,000; Full time

Job summary

Eclat-Health-Solutions-4 is searching for an experienced Multispecialty Surgery Coding Expert to act as a Subject Matter Expert. Located in Hyderabad, the candidate will provide expertise in surgical coding, conduct audits, and train fellow coders on best practices. A minimum of 6 years in multispecialty coding is required, along with relevant certifications such as CPC, CCS, CIC, or COC. This is an opportunity to play a pivotal role in ensuring accurate and compliant surgery coding in a dynamic healthcare environment.

Qualifications

• Minimum 6+ years of multispecialty professional and facility coding experience.
• Excellent knowledge of NCCI edits, modifiers, and payer-specific guidelines.
• Prior experience as an SME, trainer, or auditor in coding operations preferred.

Responsibilities

• Serve as the go-to resource for multispecialty surgical coding questions.
• Perform accurate coding for complex surgical procedures across specialties.
• Conduct audits, root cause analysis, and compliance reviews.

Skills

Surgical coding

Analytical skills

Communication skills

Problem-solving

Education

CPC, CCS, CIC, or COC Certification

Tools

3M

Optum

Encoder

Job description

Multispecialty Surgery Coding – SME (Professional & Facility)

Job Summary:

We are seeking an experienced Multispecialty Surgery Coding Expert to serve as a Subject Matter Expert (SME) for both professional and facility surgery coding. The SME will provide in-depth knowledge, training, auditing, and guidance on complex surgical coding across multiple specialties, ensuring compliance with ICD-10-CM, CPT, HCPCS, CMS guidelines.

Key Responsibilities:

• Serve as the go‑to resource for multispecialty surgical coding questions (professional and facility).
• Perform accurate coding for complex surgical procedures across multiple specialties, including orthopedic, cardiovascular, neurological, digestive, urology, general surgery, IVR and transplant cases.
• Review operative reports, anesthesia notes, and other clinical documentation to ensure correct code assignment.
• Provide training, mentoring, and support to coders and auditors on complex surgical scenarios.
• Conduct audits, root cause analysis, and compliance reviews to identify coding/documentation gaps.
• Stay updated on official coding guidelines (CMS, AHA Coding Clinic, CPT Assistant, OIG, and payer‑specific policies).
• Develop best practices, SOPs, and workflow improvements for professional and facility surgery coding.

Qualifications & Skills:

• Certification: CPC, CCS, CIC, or COC required (CCDS or CCDS‑O preferred).
• Experience: Minimum 6+ years of multispecialty professional and facility coding experience, with a strong focus on surgical coding.
• Excellent knowledge of NCCI edits, modifiers, and payer‑specific guidelines.
• Prior experience as an SME, trainer, or auditor in coding operations preferred.
• Strong analytical, problem‑solving, and communication skills.
• Proficiency in 3M, Optum, Encoder, or other leading HIM/coding applications.