Non-Clinical Job at Optum
A rare chance has emerged for qualified candidates to join Optum India as a Clinical Investigator. This Non-Clinical Job at Optum offers an opportunity to contribute to health optimisation efforts while working with a global organisation dedicated to improving health outcomes. Interested applicants are encouraged to apply before the deadline.
About Optum:
Optum India is part of UnitedHealth Group, a global organisation that delivers technology-enabled care to help millions of people live healthier lives. The organisation focuses on connecting individuals with the care, pharmacy benefits, data, and resources they need to achieve optimal health. With a culture guided by inclusion and a commitment to career development, Optum India aims to make a significant impact on the communities it serves.
Job Details:
- Job Title: Clinical Investigator
- Requisition number: 2389227
- Job category: Claims
- Primary location: Noida, India
- Overtime status: Exempt
- Travel: No
Job Description:
Positions in this function are responsible for investigating, recovering, and resolving various types of claims for health plans, commercial customers, and government entities. Responsibilities include initiating calls to members, providers, and insurance companies to gather data, pursuing recoveries on subrogation claims, and ensuring compliance with state and federal policies.
Key Responsibilities:
- Prevent the payment of potentially fraudulent and/or abusive claims utilizing medical expertise and knowledge of CPT/diagnosis codes.
- Adhere to state and federal compliance policies and contract compliance.
- Assist the prospective team with special projects and reporting.
- Work independently without established procedures.
- Act as a resource for others and coordinate activities.
- Comply with the terms and conditions of the employment contract and company policies.
Eligibility Criteria for the Non-Clinical Job:
- Graduation – B.Sc. Nursing and BDS with 1 year of corporate experience.
- Certified coder through AAPC (CPC Only accepted).
- Experience Range – >1 Year in specialty coding such as E&M, surgery, anesthesia, etc.
- Extensive work experience within the function.
- Proven attention to detail and quality focus.
- Good analytical and comprehension skills.
Preferred Qualifications for the Non-Clinical Job:
- Claims processing experience.
- Health insurance knowledge and managed care experience.
- Knowledge of US healthcare and coding.
- Familiarity with medical records.
Documents Required:
- Resume/CV
- Relevant certifications
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