Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get.
Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about another gadget, it's about making health care data available wherever and whenever people need it, safely and reliably.
There's no room for error. Join us and start doing your life's best work.(sm)
Employees are responsible for triaging, investigating and resolving instances of healthcare fraud and / or abusive conduct by medical professionals.
Using information from tips and complaints from plan members, the medical community and law enforcement, employee's conduct confidential investigations and document relevant findings and report any illegal activities in accordance with all laws and regulations.
May conduct onsite provider claim and / or clinical audits (utilizing appropriate personnel) to gather and analyze all necessary information and documents related to the investigation.
Identify, communicate and recover losses as deemed appropriate. Where applicable, testimony regarding the investigation may be required.
May also complete root cause analysis.
Jobs in this function provide coding and coding auditing services directly to providers. This includes the analysis and translation of medical and clinical diagnoses, procedures, injuries, or illnesses into designated numerical codes.
Some work is completed without established procedures. Basic tasks are completed without review by others. Supervision / guidance is required for higher level tasks.
Primary Responsibilities :
The Company may adopt, vary or rescind these policies and directives in its absolute discretion and without any limitation (implied or otherwise) on its ability to do so
Required Qualifications :
Preferred Qualifications :
Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make the health system work better for everyone.
So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve.
Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential.
For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.(sm)
Diversity creates a healthier atmosphere : Optum is an Equal Employment Opportunity / Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.
Optum is a drug-free workplace. 2021 Optum Global Solutions (Philippines) Inc. All rights reserved.
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