Health Admin Services Associate - INC

Accenture PLC; Navi Mumbai; On-site; INR 420,000 - 620,000; Full time

Job summary

Accenture PLC in India is seeking a Health Admin Services Associate to support the administration of health claims, including registrations, edits, verifications, evaluations, and litigation support. The role requires 3–5 years of Appeals and Grievance experience and a graduate degree.

You will contribute to audits, client reviews, and transition activities within the Healthcare Claims team, handling core claim processing tasks and related activities, with potential rotational shifts.

Qualifications

• Experience in appeals and grievance processes.
• Audits and client reviews support experience.
• Work with healthcare claims processing and transition/training.

Responsibilities

• Resolve complex case escalations.
• Support regulations, compliance and policy interpretation.
• Conduct quality reviews and calibration sessions.
• Deliver process training and refreshers.
• Drive process improvement initiatives.
• Support IDR and correspondence workflows.
• Interact with peers and supervisors; limited client exposure.

Skills

Claims Administration

Education

Any Graduation

Job description

Job Description:

Skill required: Claims Appeals - Claims Administration

Designation: Health Admin Services Associate - INC

Qualifications: Any Graduation

Years of Experience: 3-5 yrs

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?

• Experience supporting audits and client reviews.


• Process transition and training experience.


• 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 degree.


• 4 to 6 years of Appeals and Grievance experience.


• Subject Matter Expertise in Appeals (Commercial and or Medicare)

Roles and Responsibilities:

• esolve complex case escalations.


• Support regulations, compliance, and policy interpretation.


• Conduct quality reviews and calibration sessions.


• Deliver process training and refreshers.


• Drive process improvement initiatives.


• Support IDR and Correspondence workflows.


• In this role you are required to do analysis and solving of lower-complexity problems.


• Your day to day interaction is with peers within Accenture before updating supervisors.


• In this role you may have limited exposure with clients and or Accenture management.


• You will be given moderate level instruction on daily work tasks and detailed instructions on new assignments.


• The decisions you make impact your own work and may impact the work of others.


• You will be an individual contributor as a part of a team, with a focused scope of work.


• Please note that this role may require you to work in rotational shiftsAny Graduation

About Accenture

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.

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.