Hyderabad Telangana Claim investigation claims Jobs – 19 Open Jobs Today

Senior Clinical Administrative Coordinator - Medical Coding
Optum —Hyderabad, Telangana
- Full-time
- Analysis skills
- Presentation skills
- Bachelor's degree
- Health insurance
Claims Management - Vice President
State Street —Hyderabad, Telangana
- Full-time
- Medicine
- Management
- Analysis skills
- Health insurance
12d
Test Lead
Cognizant —Hyderabad, Telangana
- Full-time
- Hybrid work
- Oracle
- SQL
- Analysis skills
10d
Operations Manager III, POE Operations - Hyderabad
ADCI HYD 16 SEZ —Hyderabad, Telangana
- Full-time
- Microsoft Excel
- Management
- SQL
FX Confirmations & Settlements, Emerging Lead
State Street —Hyderabad, Telangana
- Full-time
- Microsoft Access
- Finance
- Master's degree
- Health insurance
Card Services Specialist
NationsBenefits, LLC —Hyderabad, Telangana
- Full-time
- Microsoft Excel
- Financial services
- Communication skills
Quick apply
10d
Internal Auditor
Prasad Hospitals India Pvt Ltd —Manikonda, Hyderabad, Telangana
- ₹15,000 - ₹60,000 a month
- Full-time
- Microsoft Excel
- Finance
- Master's degree
- Health insurance
- Paid time off
Quick apply
Private Investigator
Ingenious Ideas —Hyderabad, Telangana
- ₹15,000 - ₹30,000 a month
- Part-time
- In-person
Quick apply
Senior Executive – Audit Operations
Sagility —Hyderabad
Card Services Supervisor
NationsBenefits, LLC —Hyderabad, Telangana
- Full-time
- Microsoft Excel
- Financial services
- Communication skills
Quick apply
10d
Trainee Process Consultant
Sagility —Hyderabad
Customer Support Executive (CSE)
sagility —Hyderabad, Telangana
- Up to ₹26,000 a month
- Full-time
- 12th Pass
- Commuter assistance
- Health insurance
Quick apply
Sr.Exective-Aarogyasri Billing & NFC Billing
PRASAD HOSPITALS —Pragathi Nagar, Hyderabad, Telangana
- ₹22,000 - ₹25,000 a month
- Full-time
- Bachelor's degree
- In-person
- Medical terminology
Quick apply
1d
Product Support Engineer
Sureify Labs —Hyderabad, Telangana
- Weekend availability
- Computer Science
- Software troubleshooting
- Java
- Health insurance
Quick apply
Billing Executive
Crissfinancial —Kompally, Hyderabad, Telangana
- Full-time
- Master's degree
- Administrative experience
- Bachelor's degree
Quick apply
8d
Fitout Hiring | MEP/EHS/C&I/Coordinator | Project Management | Bangalore & Hyderabad
Colliers —Hyderabad, Telangana
- Full-time
- Project management
- Electrical experience
- Bachelor's degree
Quick apply
City Maintenance Manager (Hyderabad)
Moove —Hyderabad, Telangana
- Customer service
- Microsoft Office

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Claims Management - Vice President
State Street —Hyderabad, Telangana
Act as an extension of our client service model ensuring seamless service delivery across Business Operations for our clients. Who we are looking for.
12d

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Senior Clinical Administrative Coordinator - Medical Coding

Optum -
Hyderabad, Telangana

Apply Now

Job details

Full-time

Benefits

Health insurance

Qualifications

Medical coding
Analysis skills
Presentation skills
Bachelor's degree
CPT coding
Medical imaging
Billing
Communication skills
Physiotherapy

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.

High Level Overview of the Role

Prepay Coding Investigation Consultant is responsible for investigating and resolving instances of healthcare fraud and abuse of medical providers. Coding Investigation Consultant uses information from a tip, member benefits, and medical records to document relevant findings. This position will achieve applicable targets and metrics as determined. As a senior level staff person, this individual will provide mentoring, explanations, and feedback to others on difficult issues. This position assists with projects both internal and external to the team. The Coding Investigation Consultant provides coding guidance to investigators on CPT codes relevant to an investigation. This position works with minimal guidance and seeks input on the most complex of tasks. Works with internal and external stakeholders to facilitate client requests and maintains compliance with regulatory requirements.

Primary Responsibilities:

Day to Day:
- Reviews prepay claims with corresponding medical records to determine payment accuracy
- Reviews applicable policies, CPT guidelines and contracts as they pertain to clinical review
- Participates in regulatory meetings with client
- Participates in meetings with providers, advocates and legal to assist with provider abrasion
- Performs additional projects as needed by the business or Client; analyzes data; meets with internal and external stakeholders as necessary for resolution
- Continuous monitoring of claim inventory in order to adhere to performance guarantees
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 regard 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:

Graduate of minimum 4-year course of Allied Medical Health
Certified Professional Coder - CPC
1+ years clinical/coding experience (surgical, hospital, clinic settings).
1+ years of BPO experience
CPT & ICD coding experience required or must pass AAPC CPC Certification provided by Optum
Thorough knowledge of PC based software
Demonstrates critical thinking, problem solving, and analytical skills

Preferred Qualifications:

Graduates of Allied Medical Health (Registered Nurse/Physiotherapist/Radiologic Technologist/ Pharmacist)
Experience with health insurance billing/coding
Ability to prioritize and manage multiple tasks
Proven ability to work in a team setting
Proven excellent oral and written communication skills and presentation skills.

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

claim investigation claims jobs in hyderabad telangana

Senior Clinical Administrative Coordinator - Medical Coding

Claims Management - Vice President

Test Lead

Operations Manager III, POE Operations - Hyderabad

FX Confirmations & Settlements, Emerging Lead

Card Services Specialist

Internal Auditor

Private Investigator

Senior Executive – Audit Operations

Card Services Supervisor

Trainee Process Consultant

Customer Support Executive (CSE)

Sr.Exective-Aarogyasri Billing & NFC Billing

Product Support Engineer

Billing Executive

Fitout Hiring | MEP/EHS/C&I/Coordinator | Project Management | Bangalore & Hyderabad

City Maintenance Manager (Hyderabad)

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