Join Optum as a Clinical Investigator in Chennai! This exciting opportunity is perfect for CPC-certified freshers and experienced medical coding professionals seeking pharma jobs and healthcare careers in India. Build a rewarding career in clinical claims investigation with a global leader.
Contents
About the Company
Optum, a UnitedHealth Group company, is a leading healthcare technology and services organization dedicated to making healthcare easier, more affordable, and more connected. With nearly 300,000 employees worldwide, Optum combines clinical expertise, advanced technology, and data analytics to deliver better health outcomes for millions.
Headquartered in Eden Prairie, Minnesota, the company excels in value-based care, pharmacy services, and insights that simplify complex healthcare processes while maintaining the highest standards of regulatory compliance and innovation.
Job Details
- Company Name: Optum (UnitedHealth Group)
- Experience: 0-4 years
- Qualification: CPC Certified (AAPC) mandatory; Any Graduate (experienced) or BHMS/BAMS/BUMS/BPT/MPT/B.Sc Nursing (freshers)
- Location: Chennai
- Work Type: On-site
Job Description
Optum is actively hiring Clinical Investigators for its Chennai operations to strengthen its clinical claims review and compliance team. This role plays a vital part in ensuring accurate, ethical, and fraud-free healthcare claims processing using deep clinical and coding knowledge.
Clinical Investigator
- Department: Claims / Clinical Operations
- Market: Healthcare / Insurance
- Role: Clinical Investigator
- Experience: 0-4 years
- Education/Qualification: CPC (AAPC) Certification mandatory; relevant degrees as per eligibility
Skills/Qualifications
- CPC Certification from AAPC (mandatory)
- Strong knowledge of CPT codes, diagnosis coding, and CMC guidelines
- Experience in medical coding (Non-HCC) for experienced candidates
- Clinical background in BHMS, BAMS, BUMS, BPT, MPT, or B.Sc Nursing for freshers
- Ability to interpret member policies and payer guidelines
- Excellent analytical and decision-making skills
- Strong understanding of state, federal, and client-specific compliance requirements
- Capability to work independently in complex scenarios
Key Responsibilities
- Review and prevent fraudulent or abusive claims using clinical expertise
- Apply CPT, diagnosis coding, and CMC guidelines effectively
- Investigate claims by referencing member policies and payer guidelines
- Adhere to all regulatory and client compliance policies
- Support audits, special projects, and reporting activities
- Serve as subject matter expert and assist team coordination
- Ensure strict organizational and regulatory standards compliance
Benefits/Perks
- Career growth opportunities in a global healthcare leader
- Continuous learning and professional development programs
- Competitive salary and comprehensive benefits package
- Collaborative work culture focused on innovation and inclusion
- Global exposure and impact on healthcare outcomes
- Work-life balance with modern workplace practices
How to Apply
Interested CPC-certified candidates can apply directly by sending their updated resume to dineshvenkatasai.babu@optum.com or call 91500 32821 for more details.
Apply now to become part of a team building a healthier future at Optum! For more pharmaceutical and healthcare jobs across India, visit Pharma Recruiter.
Why You Should Join
Optum fosters a culture of integrity, compassion, and innovation where your clinical expertise directly contributes to better patient care. Employees enjoy long-term career stability, recognition for their contributions, and continuous learning opportunities in a dynamic, technology-driven environment. Joining Optum means aligning with a company that values compliance excellence while pushing boundaries in healthcare transformation.
FAQs
Q1: Is CPC certification mandatory for the Clinical Investigator role at Optum Chennai?
Yes, CPC Certification (AAPC) is mandatory for all applicants.
Q2: What qualifications are required for freshers?
Freshers with BHMS, BAMS, BUMS, BPT, MPT, or B.Sc Nursing degrees are eligible if CPC certified.
Q3: What is the experience range for this position?
The role is open to candidates with 0-4 years of experience, including freshers and those with medical coding background.
Q4: How can I grow my career at Optum?
Optum offers strong learning opportunities, mentorship, and paths for advancement in clinical and compliance domains within its global operations.
