9 Healthcare Claims Jobs

As a Health Admin Services New Associate at Accenture, you will be a part of the Healthcare Claims team responsible for the administration of health claims, including health, life, and property & casualty claims. Your main responsibilities will include registering claims, editing & verification, claims evaluation, and examination & litigation. Your role involves 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. **Key Responsibilities:** - Registering health claims - Editing and verifying claims - Evaluating claims - Examining and...

The objective of this position is to support the Luminare Health HCM Quality Management (QM) processes by performing clerical and administrative tasks aligned with quality management policies and procedures The role requires leveraging strong analytical, communication, collaboration, and problem-solving skills to ensure the successful execution of assigned responsibilities 1.2 Business environment Vertical: US Healthcare Insurance Process Name: Luminare Health HCM Quality Management Scope: Perform clerical tasks related to quality management policies and procedures as assigned, utilizing analytical, communication, collaboration, and problem-solving skills Perform administrative functions as ...

Role Overview: As a Health Admin Services New Associate at Accenture, you will be embedded in digital transformation in healthcare operations, driving superior outcomes and value realization today while enabling streamlined operations to serve the emerging health care market of tomorrow. You will be a part of the Healthcare Claims team responsible for the administration of health claims, including core claim processing such as registering claims, editing & verification, claims evaluation, and examination & litigation. Key Responsibilities: - Registering health, life, and property & causality claims - Editing and verifying claim details - Evaluating claims - Handling examination & litigation ...

Role Overview: As a Health Admin Services New Associate at Accenture, you will be a part of the Healthcare Claims team responsible for the administration of health claims. Your role will involve core claim processing tasks such as registering claims, editing & verification, claims evaluation, and examination & litigation for health, life, and property & causality claims. You will play a crucial role in embedding digital transformation in healthcare operations end-to-end, driving superior outcomes and value realization today, while enabling streamlined operations to serve the emerging health care market of tomorrow. Key Responsibilities: - Registering health claims and ensuring accuracy and c...

Role Overview: As a Health Admin Services New Associate at Accenture, you will be part of the Healthcare Claims team responsible for the administration of health claims. Your role involves core claim processing, such as registering claims, editing & verification, claims evaluation, and examination & litigation. You will play a vital role in 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. Key Responsibilities: - Solve routine problems, largely through precedent and referral to general guidelines - Interact primarily within your ...

You will be responsible for processing healthcare claims by reviewing and adhering to established policies and procedures. This includes verifying patient demographics, insurance information, and medical coding accuracy, as well as ensuring all necessary documentation is submitted with the claims. In cases of claim discrepancies and denials, you will conduct research and resolve the issues effectively. Monitoring clearinghouse rejections and claim edits within the core billing system will also be a key part of your role. Analyzing rejection and edit reports to identify root causes of claim issues, correcting errors, and working with clearinghouse representatives to resolve technical issues a...

As an Executive in the US Medicare Process team, you will be responsible for managing healthcare claims, verifying medical eligibility, and ensuring compliance with Medicare guidelines. With 1-4 years of experience in the field, you will play a crucial role in processing Medicare claims accurately and resolving any discrepancies that may arise. Your role will involve handling inbound and outbound calls for claim inquiries, updating medical eligibility records as per Medicare regulations, and reviewing healthcare provider documentation in alignment with US Medicare standards. Your key responsibilities will include processing Medicare claims with precision, verifying and updating medical eligi...

As a Health Admin Services New Associate at Accenture, you will be a part of the Healthcare Claims team responsible for the administration of health claims. Your role will involve core claim processing tasks such as registering claims, editing & verification, claims evaluation, and examination & litigation for health, life, and property & causality claims. You will play a crucial role in embedding digital transformation in healthcare operations end-to-end, driving superior outcomes and value realization today, while enabling streamlined operations to serve the emerging health care market of tomorrow. We are looking for individuals who are adaptable, flexible, and have a commitment to quality...

Designation: SME - Denial Management Experience: 2-3 years Skills desired: Detailed knowledge of US healthcare billing cycle Experience working with different EMR/EHR systems like Epic, Cerner, Allscripts, Athenahealth, NextGen, eClinicalWorks, Meditech, etc. Denial analysis and management - Review and analyze denied insurance claims to identify cause of denials such as coding issues, preauthorization, payer-specific policies - Develop and track denial log to monitor patterns and trends in denied claims - Experience talking with payers to obtain clarification with denials and initiate timely appeals when appropriate Expertise in working with denial reason codes (CARC, RARC) and identifying r...