Medical Job Opportunity at Optum: Apply for a Senior Clinical Admin Coordinator Role
Looking for a rewarding medical job in a global healthcare organization? Optum is offering a Senior Clinical Admin Coordinator – Medical Coding role in Hyderabad, Telangana. This opportunity is ideal for professionals seeking growth in clinical jobs while contributing to healthcare fraud prevention, compliance, and coding accuracy as part of Optum careers in India.
Job Details:
- Job Position: Senior Clinical Admin Coordinator – Medical Coding
- Job ID: 2342267
- Job Category: Medical & Clinical Operations
- Location: Hyderabad, Telangana, India
Qualifications:
Required:
- Graduate of a minimum 4-year course in Allied Medical Health
- Certified Professional Coder (CPC)
- 1+ years of clinical/coding experience (surgical, hospital, clinic settings)
- 1+ years of BPO experience
- CPT & ICD coding experience or ability to pass the AAPC, CPC Certification provided by Optum
- Thorough knowledge of PC-based software
- Strong critical thinking, problem-solving, and analytical skills
Preferred:
- Graduates of Allied Medical Health
- Experience with health insurance billing and coding
- Ability to prioritize and manage multiple tasks
- Ability to work effectively in a team setting
- Excellent oral and written communication skills
About the Company:
Optum is a global organization that delivers care, aided by technology, to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data, and resources they need to feel their best. Through Optum careers, employees experience a culture guided by inclusion, talented peers, comprehensive benefits, and career development opportunities. This medical job allows professionals to make a meaningful impact while advancing health optimization on a global scale.
Job Description:
This medical job, as a Prepay Coding Investigation Consultant, is responsible for investigating and resolving instances of healthcare fraud and abuse by medical providers. The Coding Investigation Consultant uses information from a tip, member benefits, and medical records to document relevant findings while achieving applicable targets and metrics.
Key Responsibilities:
- Reviews prepay claims with corresponding medical records to determine payment accuracy
- Reviews applicable policies, CPT guidelines, and contracts as they pertain to clinical review
- Participates in regulatory meetings with clients
- Participates in meetings with providers, advocates, and legal teams
- Performs additional projects, analyzes data, and collaborates with stakeholders for resolution
- Continuous monitoring of claim inventory to adhere to performance guarantees
- Complies with employment contract terms, company policies, and operational directives
