At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We are committed to mitigating our environmental impact and delivering equitable care that addresses health disparities and improves health outcomes.
Job Description:
Optum, a global organization that delivers care through technology to help millions live healthier lives, is seeking a Clinical Investigator in Noida, Uttar Pradesh. Join us in making an impact on the communities we serve as we advance health equity on a global scale. You’ll work with talented peers in a culture guided by diversity and inclusion, supported by comprehensive benefits and career development opportunities.
Key Responsibilities:
- Prevent the payment of potentially fraudulent and/or abusive claims by utilizing medical expertise, CPT/diagnosis codes, CMC guidelines, and client-specific guidelines.
- Identify discrepancies between medical records and billed services, focusing on Up-coding, Unbundling, Duplication, and Misrepresentation of services.
- Approve or deny claims and identify provider aberrant behavior patterns.
- Assist the prospective team with special projects and reporting.
- Ensure adherence to state and federal compliance policies, contract compliance, and company policies.
Required Qualifications:
- Education: Medical degree – Graduate or Postgraduate in BHMS, BAMS, BUMS, BPT, or BSc-Nursing.
- Experience: 0 to 5 years (Freshers are welcome to apply).
- Skills: Strong attention to detail, quality-focused, and good comprehension skills.
- Note: Graduates with BA, BBA, BBE, BCOM, B-Tech, M-Tech, B-Pharma, M-Pharma, or D-Pharma degrees, and BDS/MDS candidates without previous corporate experience are not eligible to apply.
Perks and Benefits:
- Work from office role with Monday to Friday working hours.
- Fixed off on Saturdays & Sundays.
- Free cab facility.
- Competitive salary with quarterly incentives.
- Provident Fund and Insurance cover for self and family.
