Non-Clinical Job at Optum India, Hyderabad

Optum India (UnitedHealth Group) is hiring a Clinical Investigator in Hyderabad. Required qualifications for this Non-Clinical Job include graduation, with BHMS, BAMS, BUMS, BPT or MPT preferred. Apply through the UnitedHealth Group careers listing.

About Optum:

Optum is a global organisation 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. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities.

Job Details:

  • Position: Clinical Investigator (Medical Review)
  • Location: Hyderabad
  • Requisition number: 2397884
  • Job category: Claims
  • Primary location: Hyderabad, India
  • Overtime status: Exempt
  • Travel: No

Primary Responsibilities of the Non-Clinical Job:

  • Prevent the payment of potentially fraudulent and/or abusive claims utilising medical expertise, knowledge of CPT or diagnosis codes, CMS guidelines, along with referring to client-specific guidelines and member policies
  • Adherence to state and federal compliance policies and contract compliance
  • Assist the prospective team with special projects and reporting
  • Coordinate with all team members and share recent process-related updates
  • Comply with all applicable Company policies, procedures, and business directives, including changes relating to work location, team assignments, work schedules, and flexible work arrangements.

Required Qualifications:

  • Graduation – Any Graduate, BHMS/BAMS/BUMS/BPT/MPT (preferred)
  • B.Sc. Nursing and BDS with 1+ years of corporate experience
  • Certified coder through AAPC
  • Certifications accepted – CPC only
  • 1+ years of experience (if not a medical graduate) – speciality coding such as E&M, surgery, anaesthesia, etc., but not only HCC
  • Extensive work experience within own function
  • Proven attention to detail & Quality focused
  • Proven excellent analytical & 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

CLICK HERE TO APPLY NOW