Non-Clinical Job at Optum
A rare chance has emerged for aspiring healthcare professionals as Optum invites applications for the position of Clinical Investigator in Noida, India. This Non-Clinical Job is perfect for candidates with a BDS qualification and relevant experience. Interested applicants are encouraged to apply before the deadline.
About Optum:
Optum is a global organisation that delivers care, aided by technology to help millions of people live healthier lives. The organisation is committed to improving health outcomes by connecting individuals with necessary care, pharmacy benefits, data, and resources. Optum fosters a culture of inclusion, offers comprehensive benefits, and provides career development opportunities to its employees.
Job Details:
- Job Title: Clinical Investigator
- Location: Noida, India
- Requisition Number: 2389227
- Job Category: Claims
- Overtime Status: Exempt
- Travel: No
Job Description:
Positions in this function are responsible for investigating, recovering, and resolving all types of claims as well as recovery and resolution for health plans, commercial customers, and government entities. This may include initiating telephone calls to members, providers, and other insurance companies to gather coordination of benefits data. The role requires ensuring adherence to state and federal compliance policies, reimbursement policies, and contract compliance.
Key Responsibilities:
- Prevent the payment of potentially fraudulent and/or abusive claims utilizing medical expertise and knowledge of relevant guidelines.
- Adhere to state and federal compliance policies and contract compliance.
- Assist the prospective team with special projects and reporting.
- Work independently, often without established procedures.
- Act as a resource for others and coordinate activities as necessary.
- Comply with the terms and conditions of the employment contract and company policies.
Eligibility Criteria for the Non-Clinical Job:
- Minimum 12 months in the current role.
- Not on Active CAP at the time of applying.
- Employees at SG 22 and SG 23 are eligible.
- Employees must notify their Current Manager before applying.
- Last Common Review rating should be Meeting Expectations or Exceeding Expectations.
Required Skills:
- BDS with 1 year of corporate experience.
- Certified coder through AAPC.
- Experience Range -> 1 year in speciality coding.
- Proven attention to detail and quality-focused.
- Good analytical and comprehension skills.
Preferred Qualifications for the Non-Clinical Job:
- Claims processing experience.
- Health Insurance knowledge, managed care experience.
- Knowledge of US Healthcare and coding.
- Medical record familiarity.
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