Job Title: Process Associate – Medical & Clinical Operations
Requisition ID: 2341405
Location: Chennai, Tamil Nadu, India
Employment Type: Full-Time
Industry: Healthcare Operations | Clinical Support Services
Optum is a global healthcare solutions provider leveraging technology, analytics, and clinical expertise to improve health outcomes worldwide. With a strong operational footprint across healthcare services, the organization supports providers, payers, and members through data-driven, compliant, and quality-focused processes.
This opportunity is ideal for professionals seeking to build a career in healthcare operations, investigations support, and clinical process management within a structured, high-performance environment.
The Process Associate – Medical & Clinical Operations is responsible for managing administrative intake, referrals, prior authorizations, and clinical documentation support in a high-volume healthcare operations setting.
The role requires professionals with relevant exposure to investigations processes, evidence gathering, fact-finding, and analytical review. Candidates must demonstrate strong documentation handling skills, data analysis capabilities, and customer service expertise.
This is a fast-paced, customer-facing position requiring efficiency, accuracy, and the ability to handle member and provider inquiries over phone and digital systems.
Manage administrative intake of members and process service-related requests.
Coordinate with hospitals, clinics, healthcare facilities, and clinical teams to manage member and provider service requests.
Process incoming and outgoing referrals and prior authorizations, including:
Intake management
Notifications
Census roles
Support clinical staff by organizing documentation and triaging cases for Clinical Coverage Review.
Conduct investigations-related activities, including fact-finding and evidence analysis.
Resolve inquiries and service requests from members and providers in a timely manner.
Maintain compliance with company policies, healthcare regulations, and employment guidelines.
Operate efficiently in a high-volume, customer service-driven environment.
Work flexible schedules, including evening shifts, based on operational requirements.
Undergraduate or postgraduate degree (Non-Medical Science and Non-Life Science graduates only).
Experience Required:
1–3 years of relevant experience in healthcare operations, investigations process support, customer service, or clinical administration preferred.
Freshers with strong analytical and documentation skills may be considered based on competency.
Working knowledge of HIPAA regulations and protected health information (PHI) confidentiality standards.
Ability to review documentation and medical record forms and make independent decisions within defined job scope.
Strong collaboration skills with the ability to work effectively in cross-functional teams.
Willingness to work occasional off-hours or flexible shifts as required.
Proficiency in MS Office tools (Excel, Word, PowerPoint).
Strong data analysis and reporting skills.
Excellent verbal and written communication skills.
High attention to detail with strong organizational abilities.
Self-motivated with the ability to meet deadlines in a structured workflow environment.
Healthcare process management
Investigations and evidence-based analysis
Prior authorization and referral processing
HIPAA compliance and data confidentiality
Customer service excellence
Documentation accuracy and review
Analytical thinking and decision-making
This role operates in a structured, high-volume healthcare operations setting requiring consistent productivity, accuracy, and professional communication. The position may involve telephonic interaction with members and providers and requires adaptability to evolving business needs.
This position offers a structured entry point into global healthcare operations, clinical support processes, and investigations workflow management. It provides exposure to regulatory compliance, healthcare documentation standards, and cross-functional clinical collaboration.
Professionals looking to build a long-term career in healthcare operations, payer services, or clinical administration are encouraged to apply.
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