Skill required: Claims Appeals - Claims Administration

Designation: Health Admin Services New Associate

Qualifications:Any Graduation

Years of Experience:0 to 1 years

About Accenture

Accenture is a global professional services company with leading capabilities in digital, cloud and security.Combining unmatched experience and specialized skills across more than 40 industries, we offer Strategy and Consulting, Technology and Operations services, and Accenture Song— all powered by the world's largest network of Advanced Technology and Intelligent Operations centers. Our 784,000 people deliver on the promise of technology and human ingenuity every day, serving clients in more than 120 countries. We embrace the power of change to create value and shared success for our clients, people, shareholders, partners and communities.Visit us at www.accenture.com

What would you do

Preferred
Exposure to Salesforce, UNET, Facets, or Case Management systems.
You will be a part of the Healthcare Claims team which is responsible for the administration of health claims This team is involved in core claim processing such as registering claims editing verification claims evaluation and examination litigation
Includes the administration of health, life, and property & causality claims.
Includes activities involved in core claim processing such as registering claims, editing & verification, claims evaluation, and examination & litigation. What are we looking for
Primary skill - Claims Administration - P1
Graduate in any discipline.
0 to 2 years of healthcare operations experience in appeals preferred.
Basic knowledge of Medicare Commercial healthcare processes.
Strong written and verbal communication skills.
Experience in Appeals, Grievances, Claims, or Authorizations Roles and Responsibilities:
Process appeals, grievances, and correspondence cases.
Perform duplicate validation and document review.
Maintain accurate notes and case documentation.
Conduct member provider outreach.
Route cases through Triage, Investigation, and Resolution queues.
Process notifications and case closure activities
In this role you are required to solve routine problems, largely through precedent and referral to general guidelines.
Your primary interaction is within your own team and your direct supervisor.
In this role you will be given detailed instructions on all tasks.
The decisions that you make impact your own work and are closely supervised.
You will be an individual contributor as a part of a team with a predetermined, narrow scope of work.
Please note that this role may require you to work in rotational shifts