Health Admin Services Associate - Voice

Accenture in India; Navi Mumbai; On-site; INR 350,000 - 550,000; Full time

Job summary

Accenture in India is hiring for Health Admin Services Associate to support claims processing, appeals, and denials management within the Healthcare Claims team. The role focuses on end-to-end appeal handling, documentation review, and collaboration with medical directors to finalize determinations.

Candidates should have 1–3 years of healthcare operations experience, with knowledge of Medicare Part C and Part D appeals and CMS regulations. Graduation is required, and shifts may be rotational.

Qualifications

• Graduate degree is required.
• Experience in healthcare claims processing preferred.

Responsibilities

• 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.
• Work in rotational shifts as required.

Skills

Payer Claims Processing

Education

Any Graduation

Job description

Job Description

Skill required

Claims Services - Payer Claims Processing

Designation

Health Admin Services Associate

Qualifications

Any Graduation

Years of Experience

1 to 3 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?

• Experience with Medicare Part C and Part D Appeals.
• Knowledge of CMS regulations and turnaround requirements.
• 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
• Business solutions that support the healthcare claim function, leveraging a knowledge of the processes and systems to receive, edit, price, adjudicate, and process payments for claims. What are we looking for?
• Primary skill - Payer Claims Processing - P1
• Graduate degree.
• 2 to 4 years healthcare operations experience.
• Experience in Medicare Appeals and Grievances processing. Roles and Responsibilities:
• 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
• In this role you are required to solve routine problems, largely through precedent and referral to general guidelines.
• Your expected interactions are within your own team and direct supervisor.
• You will be provided detailed to moderate level of instruction on daily work tasks and detailed instruction on new assignments.
• The decisions that you make would impact your own work.
• You will be an individual contributor as a part of a team, with a predetermined, focused scope of work.
• Please note that this role may require you to work in rotational shifts

Requirements