Pursue your passion and potential
Clinical Investigator
Hyderabad, India + Additional locations
Caring. Connecting. Growing together.
With these values to guide us, our people are committed to making a meaningful difference in the lives of those we are honored to serve.
Primary Responsibilities:
- Prevent the payment of potentially fraudulent and/or abusive claims utilizing medical expertise, knowledge of CPT or diagnosis codes, CMS guideline 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 the terms and conditions of the employment contract, company policies and procedures, and any and all directives (such as, but not limited to, transfer and/or re-assignment to different work locations, change in teams and/or work shifts, policies in regards to flexibility of work benefits and/or work environment, alternative work arrangements, and other decisions that may arise due to the changing business environment). The Company may adopt, vary or rescind these policies and directives in its absolute discretion and without any limitation (implied or otherwise) on its ability to do so
Required Qualifications:
- Medical degree - BHMS/BAMS/BUMS/BPT/MPT. B.Sc Nursing and BDS
- CPC Certification
- 6+ months of experience (Fresher's in BPT / MPT / BHMS/ BAMS/ BUMS can also apply)
- Extensive work experience within own function
- Proven attention to detail & quality focused
- Proven good analytical & comprehension skills
- Proven ability to work independently
Preferred Qualifications:
- Claims processing experience
- Health Insurance knowledge, managed care experience
- Knowledge of US Healthcare and coding
- Medical record familiarity
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone - of every race, gender, sexuality, age, location and income - deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.
Benefits
Our mission of helping people live healthier lives extends to our team members. Learn more about our range of benefits designed to help you live well.
Life
Resources and support to focus on what matters most to you, in every facet of your life.
Emotional
Education, tools and resources to help you reduce and manage stress, build resilience and more.
Physical
Health plans and other coverage to support wellness for you and your loved ones.
Financial
Benefits for today and to help you plan for the future, including your retirement.
We’re honored to be recognized for our exceptional work culture
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