Freshers Opportunity at Optum as Clinical Investigator
Position Name: Clinical Investigator
Organization: Optum
Location: Noida
Experience: 0 to 2 Years (Freshers Welcome)
Salary: ₹4,17,783 per annum
Qualification: BHMS, BAMS, BUMS, BPT, BSc Nursing, BDS, MDS
About Optum
Optum, part of the UnitedHealth Group, is a leading health services and innovation company that aims to help people live healthier lives. Through a combination of healthcare delivery and technology, Optum delivers care and enables millions of people to achieve better health outcomes. The company’s mission is to make the health system work better for everyone, with a focus on advancing health equity, mitigating environmental impact, and addressing health disparities.
Role Overview
The Clinical Investigator at Optum plays a critical role in preventing the payment of potentially fraudulent and/or abusive claims. This role requires a thorough understanding of medical practices, billing codes, and compliance guidelines to ensure accuracy and integrity in claim processing.
Key Responsibilities
As a Clinical Investigator, you will:
- Claims Review:
- Utilize medical expertise, CPT/diagnosis codes, CMC guidelines, and client-specific guidelines to review and analyze claims.
- Identify discrepancies between medical records and billed services, focusing on areas such as Up-coding, Unbundling, Duplication, and Misrepresentation of services.
- Decision Making:
- Approve or deny claims based on investigation findings.
- Identify and report provider aberrant behavior patterns.
- Project Assistance:
- Support the prospective team with special projects and reporting requirements.
- Compliance:
- Ensure adherence to state and federal compliance policies, contract compliance, and company policies.
Required Qualifications
Education:
- Graduate or Postgraduate in BHMS, BAMS, BUMS, BPT, or BSc Nursing.
- Note: BA, BBA, BBE, BCOM, B-Tech, M-Tech, B-Pharma, M-Pharma, or D-Pharma graduates, and BDS/MDS candidates without previous corporate experience are not eligible.
Experience:
- 0 to 2 years of experience in a relevant field. Freshers are encouraged to apply.
Skills:
- Strong attention to detail.
- Quality-focused with good comprehension skills.
- Ability to work independently and as part of a team.
Perks and Benefits
Optum offers a range of benefits designed to support your well-being and professional growth:
- Work Environment:
- Work from the office with Monday to Friday working hours. Fixed off on Saturdays and Sundays.
- Free cab facility for commuting to and from the office.
- Compensation:
- Competitive salary with quarterly incentives.
- Provident Fund and Insurance cover for self and family.
About UnitedHealth Group
UnitedHealth Group, the parent company of Optum, is a global healthcare leader with a mission to help people live healthier lives and make the health system work better for everyone. The company is committed to diversity, inclusion, and sustainability, focusing on improving health outcomes and reducing environmental impact.
How to Apply
To apply for the Clinical Investigator position at Optum, please visit the official website for more details. Ensure that you meet the required qualifications and are ready to contribute to a company that values quality, integrity, and innovation.
This job opportunity at Optum offers a chance for freshers and experienced professionals alike to build a career in a dynamic, inclusive, and impactful environment. Apply today to join a team that’s making a real difference in global healthcare!
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