Optum, a global healthcare and analytics leader, is inviting applications for the position of Clinical Investigator at its Gurugram location. This opportunity is ideal for medical graduates (BPT, MPT, BHMS, BAMS, BUMS, BDS, B.Sc Nursing) looking to build a career in healthcare analytics, medical claims review, and fraud investigation.
The Clinical Investigator role focuses on identifying discrepancies in high-value and complex medical claims, ensuring compliance with CPT codes, diagnosis codes, and clinical guidelines, and preventing potentially fraudulent or abusive claim payments.
This is a full-time, permanent, hybrid role with Monday to Friday working, competitive salary, and quarterly incentivesโmaking it a highly attractive opportunity for early-career healthcare professionals.
๐ง Key Responsibilities โ Clinical Investigator (Optum)
- Review medical records to identify up-coding, unbundling, duplication, and misrepresentation
- Prevent payment of fraudulent or abusive medical claims
- Apply medical expertise and knowledge of CPT & diagnosis codes
- Ensure adherence to CMC guidelines, client-specific policies, and member benefit plans
- Maintain compliance with state and federal healthcare regulations
- Identify provider aberrant behavior patterns
- Support team with special projects and reporting
๐ Eligibility & Qualifications
Required Education:
- Medical Degree (UG/PG):
- BPT / MPT
- BHMS
- BAMS
- BUMS
- BDS or B.Sc Nursing candidates must have minimum 1 year corporate experience
Experience:
- 6 months to 4 years of relevant experience
Key Skills:
- Strong attention to detail
- Excellent comprehension and analytical skills
- Quality-focused approach
- Understanding of healthcare documentation and billing
๐ซ Not Eligible:
BA, BBA, BBE, B.Com, B.Tech, M.Tech, B.Pharm, M.Pharm, D.Pharm graduates.
๐ฐ Salary & Benefits
- Salary: โน3.25 โ โน5.0 LPA (โน3,25,000 โ โน5,00,000 per annum)
- Quarterly Performance Incentives
- Hybrid Work Model
- Free Cab Facility
- Provident Fund (PF)
- Medical Insurance (Self & Family)
- Fixed Saturday & Sunday Off
- Stable career in a global healthcare organization
๐ Job Location
- Gurugram, Haryana, India
- Hybrid (Work from Office + Limited Remote)
๐ How to Apply
