Requirements Claims Appeals - Claims Administration Designation: Health Admin Services New Associate Requirements Years of Experience:0 to 1 years About the company 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 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 Any Graduation About the company Accenture is a leading global professional services company that helps the world’s leading businesses, governments and other organizations build their digital core, optimize their operations, accelerate revenue growth and enhance citizen services—creating tangible value at speed and scale. We are a talent- and innovation-led company with approximately 791,000 people serving clients in more than 120 countries. Technology is at the core of change today, and we are one of the world’s leaders in helping drive that change, with strong ecosystem relationships. We combine our strength in technology and leadership in cloud, data and AI with unmatched industry experience, functional expertise and global delivery capability. Our broad range of services, solutions and assets across Strategy & Consulting, Technology, Operations, Industry X and Song, together with our culture of shared success and commitment to creating 360° value, enable us to help our clients reinvent and build trusted, lasting relationships. We measure our success by the 360° value we create for our clients, each other, our shareholders, partners and communities. Visit us at www.accenture.com Equal Employment Opportunity Statement We believe that no one should be discriminated against because of their differences. All employment decisions shall be made without regard to age, race, creed, color, religion, sex, national origin, ancestry, disability status, military veteran status, sexual orientation, gender identity or expression, genetic information, marital status, citizenship status or any other basis as protected by applicable law. Our rich diversity makes us more innovative, more competitive, and more creative, which helps us better serve our clients and our communities.
