Lakshita Arora
Clinical Investigator @Optum
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WORK HISTORY
Clinical Investigator @Optum
Gurugram, IN
Reviewed 30+ high-value US medical claims/week to identify fraud patterns (up-coding, unbundling, medical necessity gaps) using CPT/ICD coding and payer guidelines, contributing to a 15–20% improvement in claims accuracy within the assigned workstream.Conducted structured fraud and aberrancy analysis across provider datasets, generating hypothesis-led insights that supported investigations and helped mitigate potential financial leakageCollaborated with supervisors and cross-functional analytics teams to refine investigation frameworks, improving fraud detection precision and strengthening data-driven decision-making across geographies.
EDUCATION
Lovely Professional University
Bachelor's degree, Physiotherapy
Delhi Public School, Dwarka
High School Diploma, PCB+Psychology
ABOUT LAKSHITA ARORA
Healthcare professional with a Bachelor’s in Physiotherapy and experience in US healthcare fraud analytics, AI-driven quality validation, and clinical research across hospital and healthtech environments. At Optum, I owned a US claims investigation workstream, reviewing 80+ high-value medical claims per week and improving claims accuracy by 15–20% through structured fraud analysis using CPT/ICD frameworks. Currently building expertise at the intersection of healthcare, analytics, and innovation by designing AI-based quality frameworks and conducting quantitative research using Excel and SPSS, while collaborating across engineering, clinical, and product teams to drive data integrity and operational efficiency. I am now exploring non-clinical medical roles, Consulting, Healthcare Strategy, Market Research, or Insights & Analytics roles where I can apply hypothesis-driven analysis, structured problem-solving, and healthcare domain expertise to generate actionable business insights and measurable impact.
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