Health Admin Services Associate - INC

Overview

Health Admin Services Associate on Accenture's Healthcare Claims team, administering health claims through core claim processing, with a focus on Medicare appeals and grievances.

What you'll do

• Handle end-to-end appeal processing.
• Perform AOR validation and provider outreach.
• Review denial rationale and supporting clinical documentation.
• Prepare cases for Medical Director review.
• Process determinations and effectuation activities.
• Administer health, life, and property and casualty claims, including registering claims, editing and verification, claims evaluation, and examination and litigation.

What you'll need

• Any graduation.
• Graduate degree.
• 2 to 4 years healthcare operations experience.
• Experience with Medicare Part C and Part D appeals.
• Experience in Medicare appeals and grievances processing.
• Knowledge of CMS regulations and turnaround requirements.

Details

• Location: Navi Mumbai.
• This role may require working in rotational shifts.