Hyderabad, Telangana Optum health care group Jobs – 178 Open Jobs Today

Clinical Investigator
Optum —Hyderabad, Telangana
- Full-time
- B.Sc
- Analysis skills
- Bachelor's degree
- Health insurance
Collections Representative - AR Calling - RCM Denial Management
Optum —Hyderabad, Telangana
- Full-time
- Microsoft Excel
- Microsoft Outlook
- HIPAA
- Health insurance
Customer Service Representative
Optum —Hyderabad, Telangana
- Full-time
- CRM software
- Customer service
- Bachelor's degree
- Health insurance
5d
Claims Associate
Optum —Hyderabad, Telangana
- Full-time
- Microsoft Word
- Microsoft Excel
- English
- Health insurance
Senior Clinical Administrative Coordinator - Medical Coding
Optum —Hyderabad, Telangana
- Full-time
- Analysis skills
- Presentation skills
- Bachelor's degree
- Health insurance
Quality Auditor
Optum —Hyderabad, Telangana
- Full-time
- Hybrid work
- Microsoft Powerpoint
- Microsoft Word
- Microsoft Office
- Health insurance
11d
Subject Matter Expert - IPDRG
Optum —Hyderabad, Telangana
- Full-time
- Anatomy knowledge
- Analysis skills
- Bachelor's degree
- Health insurance
Medical Coder - Multispecialty
Optum —Hyderabad, Telangana
- Full-time
- Anatomy knowledge
- Medical terminology
- Health insurance
Quality Consultant
Optum —Hyderabad, Telangana
- Full-time
- Azure
- APIs
- Health insurance
Technical Project Consultant
Optum —Hyderabad, Telangana
- Full-time
- Microsoft Office
- Project management
- Bachelor's degree
- Health insurance
Senior Software Engineer - JAVA ANGULAR
Optum —Hyderabad, Telangana
- Full-time
- Azure
- Java
- Master's degree
- Health insurance
Coding Quality Auditor - IVR & SDS Observation
Optum —Hyderabad, Telangana
- Full-time
- Anatomy knowledge
- Analysis skills
- Bachelor's degree
- Health insurance
Supervisor - RCM
Optum —Hyderabad, Telangana
- Full-time
- Management
- Microsoft Office
- Bachelor's degree
- Health insurance
Senior Software Engineer I
Optum —Hyderabad, Telangana
- Full-time
- Computer Science
- System design
- Java
- Health insurance
Senior Software Engineering Lead - TSQL and 837 Medical Claims
Optum —Hyderabad, Telangana
- Full-time
- SQL
- APIs
- Health insurance
Senior Clinical Informatics Analyst
Optum —Hyderabad, Telangana
- Full-time
- Microsoft Powerpoint
- Microsoft Word
- Microsoft Excel
- Health insurance
9d
Tech Product Manager
Optum —Hyderabad, Telangana
- Full-time
- Bachelor's degree
- Product management
- Agile
- Health insurance
I O Engineering Consultant- DevOps, Terraform, Azure, CI/CD
Optum —Hyderabad, Telangana
- Full-time
- Azure
- DevOps
- Java
- Health insurance
Director - Back Office RCM Operations
Optum —Hyderabad, Telangana
- Full-time
- Master's degree
- Bachelor's degree
- AI
- Health insurance
Senior Software Engineer - ADB, ADF, Snowflake
Optum —Hyderabad, Telangana
- Full-time
- Azure
- Computer Science
- Master's degree
- Health insurance

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Clinical Investigator

Optum -
Hyderabad, Telangana

Apply Now

Job details

Full-time

Benefits

Health insurance

Qualifications

B.Sc
BUMS
Analysis skills
Science
Medical records
Bachelor's degree
CPT coding
BAMS
Nursing
MPT

Full job description

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.

This process works on identifying Fraud, Waste and Abuse between medical records and billed services for complex and high value claims by identifying Up-coding, Unbundling, Duplication, and Misrepresentation of services. They approve or deny claims and Identify provider aberrant behavior patterns. The associates 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.

Fraud is intentionally misrepresenting or concealing facts to obtain something of value. The complete definition has three primary components:

Intentional dishonest action or misrepresentation of fact
Committed by a person or entity
With knowledge that dishonest action or misrepresentation could result in an inappropriate gain or benefit

This definition applies to all persons and all entities. However, there are special rules around intentional misrepresentations to Government programs such as Medicare and Medicaid, or TRICARE.

Waste includes inaccurate payments for services, such as unintentional duplicate payments, and can include inappropriate utilization and/or inefficient use of resources.

Abuse includes any practice that results in the provision of services that:

Are not medically necessary
Do not meet professionally recognized standards for health care
Are not fairly priced

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 with 1+ years of corporate experience
6+ months of experience (Fresher's in BPT / MPT / BHMS/ BAMS/ BUMS can also apply)
CPC Certification Mandate.
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.

Apply Now

Refine Your Search

optum health care group jobs in hyderabad, telangana

Clinical Investigator

Collections Representative - AR Calling - RCM Denial Management

Customer Service Representative

Claims Associate

Senior Clinical Administrative Coordinator - Medical Coding

Quality Auditor

Subject Matter Expert - IPDRG

Medical Coder - Multispecialty

Quality Consultant

Technical Project Consultant

Senior Software Engineer - JAVA ANGULAR

Coding Quality Auditor - IVR & SDS Observation

Supervisor - RCM

Senior Software Engineer I

Senior Software Engineering Lead - TSQL and 837 Medical Claims

Senior Clinical Informatics Analyst

Tech Product Manager

I O Engineering Consultant- DevOps, Terraform, Azure, CI/CD

Director - Back Office RCM Operations

Senior Software Engineer - ADB, ADF, Snowflake

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