Clinical Investigator – CPC Certified Job at Optum Noida
Optum is hiring a Clinical Investigator – CPC Certified for its Noida location. This Clinical Investigator Job role is ideal for medical graduates, pharmacists, and certified coders who want to build a career in US healthcare claims investigation, fraud prevention, and clinical claim accuracy. Join a global team that impacts millions by improving health outcomes through data-driven care. Graduates seeking for B pharma jobs or M Pharma jobs can apply now.
About the Company – Optum
Optum, part of UnitedHealth Group, is a global healthcare organization focused on improving care through technology and data-driven insights. Optum connects millions of people with the right healthcare, pharmacy benefits, and analytics support. The culture encourages inclusion, continuous learning, career growth, and making a measurable impact in global health systems. Clinical Investigator Job Role plays a significant role in the company.
Educational Requirements
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B.Pharm / M.Pharm
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CPC Certification is mandatory
Experience Requirements for Clinical Investigator Job Role:
- Experienced certified coder (minimum 6 months)
- Extensive work experience in relevant clinical/coding functions
- Strong analytical, comprehension skills
- High attention to detail and quality-driven mindset
Preferred Qualifications
- Claims processing experience
- Knowledge of U.S. healthcare and managed care systems
- Medical coding experience (CPT & ICD)
- Medical record familiarity
Key Responsibilities for Clinical Investigator Job Role:
- Prevent payment of fraudulent or abusive claims using medical expertise and CPT/Diagnosis coding
- Review prepay claims and medical records for payment accuracy
- Review policies, CPT guidelines, contracts for clinical assessment
- Participate in regulatory meetings with clients
- Support meetings with providers, advocates, and legal teams
- Analyze data and collaborate with internal/external stakeholders
- Monitor claim inventory to ensure performance guarantee compliance is required for Clinical Investigator Job
- Ensure adherence to federal & state compliance and reimbursement policies
- Assist prospective team with special projects and reporting
- Work independently and act as a resource for others when required
- May coordinate activities of other team members
- Follow all company policies and employment terms including reassignment or shift changes
Skills Required for Clinical Investigator Job Role:
- Analytical thinking
- Accuracy & attention to detail
- CPT/ICD coding knowledge
- Understanding of U.S. healthcare system
- Good communication skills
- Independent decision-making capability
How to Apply :
Interested applicants in B pharma jobs or M Pharma jobs can apply now through the Optum/UnitedHealth Group official careers portal.