Health Admin Services Specialist-Voice

8103 Acc Sol Pvt Ltd Company; Bengaluru; On-site; INR 1,200,000 - 1,800,000; Full time

Job summary

Accenture in Bengaluru is seeking an experienced Health Admin Services Specialist to oversee claims appeals within healthcare operations. You will review denied insurance claims, gather supporting information, and make fair, compliant decisions while communicating with claimants.

The role requires a BSc or Bachelor of Pharmacy and 7–11 years of relevant experience, with strong analytical and communication skills, and the ability to work under pressure in a fast-paced environment.

Qualifications

• Must hold BSc or Bachelor of Pharmacy.
• 7–11 years of experience in health insurance claims or related field.
• Experience in claims appeals / Health Admin Services Specialist.

Responsibilities

• Analyze and solve moderately complex problems in claims.
• May create new solutions by adapting existing methods.
• Understand strategic direction from senior management related to team goals.
• Interact with supervisor and possibly clients.
• Support rotational shifts and collaboration with peers.

Skills

Adaptable & flexible

Under pressure

Problem solving

Written & verbal comms

Analytical skills

Education

BSc / Bachelor of Pharmacy

Job description

Skill required: Claims Appeals - Claims Administration Designation: Health Admin Services Specialist Qualifications:BSc/Bachelor of Pharmacy Years of Experience:7 to 11 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?

Embedding digital transformation in healthcare operations end-to-end, driving superior outcomes and value realization today, and enabling streamlined operations to serve the emerging health care market of tomorrow Claims Appeals involves reviewing and processing appeals for denied insurance claims. This includes evaluating the reasons for denial, gathering additional information, and making decisions on the appeal. The goal is to ensure fair and accurate resolution of claims. Responsibilities include communicating with claimants, analyzing documentation, and adhering to regulatory guidelines. This role is essential for maintaining trust and satisfaction in the claims process. 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?

• Adaptable and flexible
• Ability to perform under pressure
• Problem-solving skills
• Written and verbal communication
• Strong analytical skills

Roles and Responsibilities:

• In this role you are required to do analysis and solving of moderately complex problems
• May create new solutions, leveraging and, where needed, adapting existing methods and procedures
• The person would require understanding of the strategic direction set by senior management as it relates to team goals
• Primary upward interaction is with direct supervisor
• May interact with peers and/or management levels at a client and/or within Accenture
• Guidance would be provided when determining methods and procedures on new assignments
• Decisions made by you will often impact the team in which they reside
• Individual would manage small teams and/or work efforts (if in an individual contributor role) at a client or within Accenture
• Please note that this role may require you to work in rotational shifts

BSc,Bachelor of Pharmacy

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. 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. Bring your incredible skills and join our global team of innovators. We come together from different backgrounds across the world and work with the latest technologies to create value and growth for our clients. With us, you’ll continue to learn and grow so you can advance in your career. Your personal dreams and ambitions are just as important to us; that’s why we offer support any way we can—when you thrive, we all thrive. Explore your next step at Accenture Belong. Grow. Thrive. Join a great place to work for reinventors who drive meaningful change for our clients, communities, and the world. Wo rld. Explore your next step at Accenture