to one of the toughest and most fulfilling ways to help people,
including yourself. We offer the latest tools, most intensive training
program in the industry and nearly limitless opportunities for
advancement. Join us and start doing your life's best work.
join a high caliber team where you're assisting, educating,
problem-solving and resolving tenuous situations to the best possible
outcomes. Bring your people skills, emotional strength and attention to
detail. In return we offer the latest tools and most intensive training
program in the industry. Get ready to start doing your life's best work.(sm)
is a quality role that supports the Optum Payment Integrity Fraud,
Waste, Abuse and Error business units. This role is responsible for the
determining the accuracy of the outcome of claim payment decisions after
clinical review of medical record submissions.
- Validate the accuracy of clinical medical record reviews and payment decisions.
- Develop and deliver fact based audit determinations.
- Serve on applicable cross-functional quality
committees and work groups to identify and communicate common quality
issues, trends, and patterns.