Clinical Services & Prior Authorization Analyst

8003 Accenture Inc Company; Quezon City; On-site; PHP 300,000 - 540,000; Full time

Job summary

Accenture is seeking a Health Clinical Services Analyst in Quezon City, Philippines to support clinical and administrative workflows. The role verifies eligibility, benefits, and handles pre-certification and prior authorization requests in client systems.

You will obtain intake information, perform data entry, and coordinate with providers and nurses to ensure accurate case creation and timely processing. Office-based at Gateway Tower 2 with local collaboration.

Qualifications

• Clinical experience in healthcare settings is required or preferred.
• Experience with intake, pre-certification and/or prior authorization workflows is a plus.
• Ability to follow scripts and data-entry processes accurately.

Responsibilities

• Determines contract; verifies eligibility and benefits.
• Conducts provider searches in client system and follows up on referrals.
• Checks benefits for facility-based treatment.
• Obtains intake information from callers, e-Reviews, and faxes.
• Processes requests for pre-certification and/or prior authorization.
• Performs data entry into client systems and routes tasks.
• Matches records and consolidates inputs for approval.
• Generates letters as directed by the client manual.
• Assigns cases and maintains workflow to meet productivity goals.
• Contacts providers to request clinical information and complete approvals.

Education

Philippines Registered Nurse license

Job description

Accenture is seeking a Health Clinical Services Analyst in Quezon City, Philippines to support clinical and administrative workflows. The role verifies eligibility, benefits, and handles pre-certification and prior authorization requests in client systems.

You will obtain intake information, perform data entry, and coordinate with providers and nurses to ensure accurate case creation and timely processing. Office-based at Gateway Tower 2 with local collaboration.