FAQs
What is the primary role of a Clinical Investigator at Optum?
The primary role involves investigating, recovering, and resolving claims for health plans, commercial customers, and government entities, as well as preventing potentially fraudulent and abusive claims.
What qualifications are required for the Clinical Investigator position?
A medical degree (BHMS/BAMS/BUMS/BPT/MPT), a B.Sc Nursing or BDS with 1 year of corporate experience, and at least 6 months of experience are required, although freshers in relevant fields can also apply.
Is prior experience in claims processing necessary for this role?
While claims processing experience is preferred, it is not strictly necessary, especially for candidates with relevant educational backgrounds.
What skills are important for a Clinical Investigator?
Important skills include attention to detail, quality focus, analytical and comprehension skills, and extensive work experience within the healthcare function.
What does the job entail in terms of compliance?
The job requires adherence to state and federal compliance policies, as well as contract compliance throughout the investigation and claims resolution process.
Are there any preferred qualifications for this position?
Yes, preferred qualifications include claims processing experience, knowledge of health insurance and managed care, familiarity with US Healthcare coding, and medical record familiarity.
What type of work environment can one expect in this position?
The work is frequently completed without established procedures and is often performed independently, but there may also be coordination of activities with others.
Can the Clinical Investigator be involved in special projects?
Yes, the Clinical Investigator may assist the prospective team with special projects and reporting.
What is the company's stance on diversity and inclusion?
Optum values diversity and inclusion, believing that everyone deserves the opportunity to live their healthiest life, and actively works towards mitigating barriers to good health for marginalized groups.
What is the mission of UnitedHealth Group, the parent company of Optum?
The mission is to help people live healthier lives and make the health system work better for everyone, addressing health disparities and improving health outcomes.