Clinical Investigator Job at Optum
Looking for Clinical Investigator Job in the healthcare industry? Optum Careers is hiring Clinical Investigators in Gurgaon for professionals passionate about healthcare claims, compliance, and fraud prevention. This opportunity is ideal for candidates seeking medical jobs in India, including eligible freshers and experienced healthcare professionals. Join a globally recognised healthcare organisation and contribute to improving health outcomes through technology-driven clinical investigation and claims management.
About Optum:
Optum is a global healthcare organisation committed to improving lives through innovative technology, data-driven healthcare solutions, and patient-centred services. Operating across multiple countries, the company connects individuals with quality care, pharmacy benefits, and healthcare resources. Optum Careers provides professionals with opportunities to work in an inclusive environment that promotes continuous learning, career growth, and meaningful contributions toward advancing healthcare worldwide.
Job Details:
- Job Role: Clinical Investigator
- Job Category: Claims
- Requisition Number: 2347869
- Location: Gurgaon, India
- Employment Type: Full-Time
- Travel: No
Job Description:
Optum is recruiting a Clinical Investigator for its Claims division in Gurgaon, India. This position focuses on investigating medical claims, preventing fraudulent payments, ensuring regulatory compliance, and reviewing medical records. Candidates interested in Clinical Investigator Jobs will work closely with healthcare providers, insurance claims, and internal teams to improve operational efficiency and healthcare outcomes. Professionals searching for medical jobs in India can benefit from this excellent career opportunity with a globally recognised healthcare organisation.
Key Responsibilities:
- Investigate healthcare claims to identify potentially fraudulent payments.
- Review medical records using clinical knowledge and established guidelines.
- Ensure compliance with state and federal regulations.
- Process claims recovery activities.
- Coordinate with healthcare providers and members.
- Assist with reporting and special projects.
- Support colleagues as a clinical resource.
- Coordinate team activities for effective workflow.
- Maintain compliance with organisational policies and quality standards.
Eligibility Criteria for this Clinical Investigator Job:
-
- BHMS
- BAMS
- BUMS
- BPT
- MPT
- BDS (1+ year corporate experience)
- Candidates with any of the following qualifications are eligible:
-
Experience:
- Freshers can apply (BPT, MPT, BHMS, BAMS, and BUMS).
- 6+ months of relevant experience preferred.
- Extensive experience in healthcare or claims is an advantage.
Required Skills for this Clinical Investigator Job:
- Claims processing experience.
- Health insurance knowledge and managed care experience.
- Familiarity with US healthcare systems and coding.
- Knowledge of medical records.
