Senior Clinical Investigator – CPC Certified job at Optum Hyderabad
If you’re experienced in medical coding, clinical investigations, and fraud-prevention in claims, Optum is offering a great opportunity as a Senior Clinical Investigator in Hyderabad. This Clinical Investigator Job role is perfect for healthcare graduates who want to work with a global team, analyze medical records, prevent inaccurate claim payments, and grow in the US healthcare domain. Graduates seeking for Pharmacy Jobs and want to build their career with Optum Careers can apply now.
Introduction of the Job
Optum is hiring experienced and CPC-certified professionals for the role of Senior Clinical Investigator in Hyderabad. This Clinical Investigator Job role involves reviewing claims, analyzing medical records, interpreting CPT/ICD codes, and preventing fraudulent or inaccurate claim payments.
Job Details :
- Job Title: Senior Clinical Investigator – CPC Certified
- Requisition Number: 2327427
- Job Category: Medical & Clinical Operations
- Location: Hyderabad, Telangana
- Investigate fraudulent/inaccurate claims
- Review CPT, diagnosis codes, medical records
- Participate in client regulatory meetings
- Assist providers, advocates, and legal teams
- Analyze data and support internal/external stakeholders
- Monitor claim inventory
- Ensure adherence to federal/state policies
About the Company
Optum is part of UnitedHealth Group, one of the world’s largest healthcare organizations. The company focuses on improving health outcomes through technology, clinical expertise, and innovation. Optum provides a diverse work culture, strong learning support, and career growth opportunities across global health systems.
Educational Requirements
-
B.Pharm / M.Pharm
Certifications Required for Clinical Investigator Job Role:
- Certified Professional Coder (CPC) – AAPC
- CPT & ICD experience or must clear CPC
Experience Required
- 6 months – 3+ years
- Experience in medical coding, claim review, or clinical investigation
- Strong analytical and comprehension skills
- High attention to detail
Preferred Qualifications for Clinical Investigator Job Role:
- Claims processing experience
- Managed care / health insurance knowledge
- US healthcare coding familiarity
- Medical record review experience
Key Responsibilities for Clinical Investigator Job Role:
- Prevent fraudulent or abusive claim payments
- Review CPT, ICD codes, and medical records
- Ensure payment accuracy
- Participate in regulatory/client meetings
- Assist legal and provider relations teams
- Handle special projects and data analysis
- Monitor claim inventory performance
- Work independently and guide others when needed
Skills Required :
- Strong coding knowledge (CPT/ICD)
- Attention to detail
- Analytical and problem-solving skills
- Ability to work independently
- Good communication and documentation skills
How to Apply for Clinical Investigator Job Role:
Graduates seeking for Pharmacy Jobs and want to build their career with Optum Careers can apply directly through the official Optum Careers portal via the external application link.