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Optum Hiring Clinical Investigator – CPC Certified | Noida | Medical Coding & Claims Job 2025
Optum (UHG)
Noida
6 Months – 1 Year
Clinical Investigator
CPC Certified
📄 Job Overview
Optum, part of UnitedHealth Group, is hiring Clinical Investigator – CPC Certified professionals in Noida. This role focuses on healthcare claims investigation, medical record review, and prevention of fraudulent or abusive claims while ensuring compliance with US healthcare regulations.
🧠Key Responsibilities
- Investigate and resolve healthcare claims for health plans
- Identify potentially fraudulent or abusive claims
- Review medical records, CPT & ICD codes
- Perform pre-pay and post-pay claim reviews
- Ensure compliance with state & federal guidelines
- Participate in provider and regulatory discussions
- Handle complex investigations independently
🎓 Eligibility & Qualifications
- B.Pharm / M.Pharm
- BHMS / BAMS / BUMS
- BPT / MPT
- B.Sc / BDS / Nursing
- CPC Certification (AAPC) – Mandatory
- Minimum 6 months coding or claims experience
⭐ Preferred Skills
- US healthcare claims processing experience
- Strong CPT & ICD coding knowledge
- Attention to detail & analytical mindset
- Understanding of reimbursement policies
📌 Note Before You Apply:
Kindly read the complete job description carefully before applying. Ensure your qualification and CPC certification match the role requirements.
Kindly read the complete job description carefully before applying. Ensure your qualification and CPC certification match the role requirements.
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