Clinical Investigator
UnitedHealth Group
- Noida, Uttar Pradesh
- Permanent
- Full-time
- Prevent the payment of potentially fraudulent and/or abusive claims utilizing medical expertise, knowledge of CPT/diagnosis codes, CMC 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
- 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
To apply to an internal job, employees must meet the following criteria:
- Minimum 12 months in the current role
- Not on Active CAP at the time of applying for the IJP
- Employees at SG 22 and SG 23 are eligible
- Employees must notify their Current Manager before applying for the IJP
- Last Common Review rating should be Meeting Expectations or Exceeding Expectations
- Medical degree - BHMS/BAMS/BUMS/BPT/MPT
- B.Sc Nursing and BDS with 1 year of corporate experience
- Experience Range - 6 months - 3 years (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
- Claims processing experience
- Health Insurance knowledge, managed care experience
- Knowledge of US Healthcare and coding
- Medical record familiarity