Clinical Investigator

4 weeks ago


Hyderabad, Telangana, India UnitedHealth Group Full time

At UnitedHealth Group, we're committed to helping people live healthier lives and making the health system work better for everyone. As a Clinical Investigator, you'll play a critical role in ensuring the integrity of our health insurance programs and protecting our members from potential fraud and abuse.

Key Responsibilities:

  • Investigate and resolve claims-related issues, ensuring compliance with state and federal regulations
  • Collaborate with cross-functional teams to identify and mitigate potential risks
  • Develop and implement strategies to prevent and detect fraudulent activity
  • Provide expert medical knowledge and analysis to support claims decisions
  • Stay up-to-date on industry trends and regulatory changes to ensure compliance

Requirements:

  • Medical degree (BHMS/BAMS/BUMS/BPT/MPT) or equivalent experience
  • Strong analytical and problem-solving skills, with attention to detail and quality focus
  • Excellent communication and interpersonal skills, with ability to work effectively in a team environment
  • Knowledge of US healthcare and coding systems, with experience in claims processing and health insurance

Preferred Qualifications:

  • Claims processing experience, with knowledge of medical records and coding systems
  • Experience working in a healthcare or insurance environment, with knowledge of regulatory requirements
  • Strong analytical and problem-solving skills, with ability to work independently and as part of a team


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