Health Admin Services Associate - INC

Overview

Join Accenture's Healthcare Claims team to administer health claims, including Medicare Part C and Part D appeals processing, as a Health Admin Services Associate.

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.
• Participate in core claim processing, including registering claims, editing and verification, claims evaluation, and examination and litigation.
• Solve routine problems, largely through precedent and referral to general guidelines.

What you'll need

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

Details

• Location: AIOC-S01672228, Navi Mumbai.
• May require working in rotational shifts.
• Individual contributor role within a team, with detailed to moderate instruction on daily tasks; interactions within own team and direct supervisor.