Medical coder or Quality Engineer

Optum India; Dadri; On-site; INR 600,000 - 1,000,000; Full time

Job summary

Optum India is seeking a QA tester to create and execute clinical and functional test cases for a claims processing product. You will validate features, rules, and compliance with US healthcare guidelines while coordinating with analysts and developers to ensure clinical accuracy.

The role emphasizes analytical thinking, clear communication, and attention to detail, with opportunities to work on complex testing environments and AI-assisted clinical testing tools.

Qualifications

• Graduate degree or equivalent experience.
• Certified Medical coder.
• Expertise in US Healthcare system with medical coding experience to perform clinical and functional testing.
• Knowledge of Quality Engineering best practices.
• Knowledge of the Agile methodology for delivering software solutions.
• Proven good analytical skills and client like testing mindset.
• Proven excellent verbal and written communication skills, problem solving and troubleshooting skills with focus on accuracy and attention to details.

Responsibilities

• Test case creation and execution.
• Testing new features being developed to ensure functional and clinical viability.
• Testing clinical rules/patterns to ensure alignment with sourced clinical guidelines.
• Ensure the product is compliant to the US Healthcare system.
• Collaborate with Business Analysts, medical coding experts and developers to ensure clinically accurate features.
• Create testing environments replicating client environments for defect research and fix.
• Provide accurate and timely estimates for tasks.

Skills

Analytical skills

Testing mindset

Verbal written communication

Problem solving

Attention to detail

Education

Graduate degree or equivalent experience

Certified Medical coder

Tools

Rally

IntelliJ

GitHub

SQL DB

Oracle

Job description

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.

Job Description

This position will be responsible for creating and executing clinical & functional test cases for a software product which works as a claim processor/claim scrubber/Clinical Rule engine.

Primary Responsibilities

• Test case creation and execution
• Testing new features being developed to make sure the product is functionally and clinically viable
• Testing clinical rules/patterns being developed to ensure the rule correctly captures the essence of the sourced clinical/medical guidelines
• Ensure the product is compliant to the US Healthcare system
• Work closely with the Business Analysts, medical/clinical coding experts to clearly understand the business requirement of feature or rules and then co-ordinate with the software developers, other team members & stakeholders to ensure the feature being delivered is clinically and functionally accurate
• Create testing environments with special focus on replicating client's environment during defect research and fix.
• Provide accurate and timely estimates for tasks
• Comply with the terms and conditions of the employment contract, company policies and procedures, and any and all directives (such as, but not limited to, transfer and/or re-assignment to different work locations, change in teams and/or work shifts, policies in regards to flexibility of work benefits and/or work environment, alternative work arrangements, and other decisions that may arise due to the changing business environment). 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

• Graduate degree or equivalent experience
• Certified Medical coder
• Expertise in US Healthcare system with medical coding experience to perform clinical and functional testing
• Knowledge of Quality Engineering best practices
• Knowledge of the Agile methodology for delivering software solutions
• Proven good analytical skills and client like testing mindset
• Proven excellent verbal and written communication skills, problem solving and troubleshooting skills with focus on accuracy and attention to details

Preferred Qualifications

• Experience on tools such as Rally, intellij, GITHUB and or other testing tools
• Working knowledge of Oracle and SQL DB
• Clinical testing and automation tools knowledge
• Proven effective utilization of AI tools in clinical testing

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.