Health Admin Services New Associate Accenture

0.0 - 3.0 years

0 Lacs

chennai, tamil nadu

On-site

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. A process-oriented mindset, results orientation, and strong written and verbal communication skills are essential for this role. As a Health Admin Services New Associate, you will be responsible for solving routine problems following general guidelines and precedents. Your primary interactions will be within your team and with your direct supervisor. You will receive detailed instructions on tasks, and decisions made will impact your work closely supervised. This role requires you to work as an individual contributor within a team with a predetermined, narrow scope of work. Please note that rotational shifts may be required for this role. If you are a recent graduate with 0 to 1 years of experience and have a passion for healthcare claims administration, this opportunity at Accenture could be the perfect fit for you. Join our global professional services company with leading capabilities in digital, cloud, and security, and be part of a team that embraces change to create value and shared success for clients, people, shareholders, partners, and communities.,

Posted 1 day ago

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SME - Denial Management Zapare Technologies

2.0 - 3.0 years

4 - 5 Lacs

Kochi, Ernakulam, Thrissur

Work from Office

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 root causes of denials. Strong understanding of billing regulations, CPT, ICD-10, HCPCS codes, and compliance standards (HIPAA, CMS guidelines). Appeals - - Understand 1st, 2nd, 3rd, and External Level Appeal process, system, and documentation SOP - Prepare, submit, and follow up on appeals ensuring all necessary documentation is included - Revie Review assigned denials and EOBs for appeal filing information. Gather any missing information - Review case history, payer history, and state requirements to determine appeal strategy - Obtain patient and/or physician consent and medical records when required by the insurance plan or state - Gather and fill out all special appeal or review forms - Create appeal letters, attach the materials referenced in the letter, and mail them Maintain a record of all appeals and responses to track appeal outcomes and recovery rates Monitor payer response timelines to ensure appeal filing deadlines are met Track insurance company and state requirements and denial trend changes

Posted 1 week ago

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