Health Admin Services New Associate at Accenture

Bengaluru, Karnataka, India

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Not SpecifiedCompensation

Entry Level & New GradExperience Level

Full TimeJob Type

UnknownVisa

HealthcareIndustries

Requirements

Any Graduation
0 to 1 years of experience
Holds current and unrestricted local (PH) Registered Nurse license
Bachelor of Science Nursing (BSN) degree
Excellent written and verbal communication skills in English
Must pass American English and alternate language fluency test ("Test") upon hire (non-US resident) by successfully completing internal written test; for voice accounts, pass US Berlitz B2 level or Versant score 58 and above
Proficiency in basic computer knowledge with the ability to learn additional computer programs
Minimum of three (3) months of prior working experience as a Registered Nurse in a clinical setting (equivalent to 480 hours providing direct patient care)
Written and verbal communication
Microsoft Excel
Microsoft PowerPoint
Related outsourcing operations experience
Claims reviews/audit experience and data entry experience
Knowledge of utilization management process and ability to interpret and apply member contracts and member benefits
Knowledge of ICD-9, ICD-10, and CPT codes (preferred)
Experience in medical or insurance field (preferred)
Strong customer service focus, ability to empathize, prioritizing customer needs
Requires analysis and solving of increasingly complex problems
Interaction with peers, supervisors, clients, and Accenture management

Responsibilities

Provide support to the clinical team and client team to assist in promoting quality member outcomes, optimizing member benefits, and promoting effective use of resources
Support procedures ensuring adherence to medical policy and member benefits for medically appropriate, high-quality, and cost-effective service
Utilization Management: Gather information using appropriate client-specific telephonic screening tools; conduct pre-review screening under guidance of US licensed health professionals
Case Management/Disease Management: Provide support functions for wellness programs, health management programs, and preventative care opportunities; gather information using client-specific telephonic screening tools
Manage incoming or outgoing telephone calls, e-Reviews, and/or faxes, including triage, opening of cases, and data entry into client system
Determine contract; verify eligibility and benefits
Conduct thorough provider radius search in client system and follow up with provider on referrals given
Check benefits for facility-based treatment
Obtain intake (demographic) information from caller, e-Reviews, and/or fax; process information
With proper guidance and oversight by Team Lead, may perform precepting, training, mentoring, and job shadowing duties

Skills

Claims Appeals

Claims Administration

Microsoft Excel

Microsoft PowerPoint

Written Communication

Verbal Communication

Claims Reviews

Claims Audit

Utilization Management

Case Management

Accenture

Global professional services for digital transformation

About Accenture

Accenture provides a wide range of professional services, including strategy and consulting, technology, and operations, to help organizations improve their performance. Their services assist clients in navigating digital transformation, enhancing operational efficiency, and achieving sustainable growth. Accenture's offerings include cloud migration, cybersecurity, artificial intelligence, and data analytics, which are tailored to meet the needs of various industries such as financial services, healthcare, and retail. What sets Accenture apart from its competitors is its extensive industry knowledge and ability to deliver comprehensive solutions that address both immediate challenges and long-term goals. The company's aim is to support clients in reducing their environmental impact while driving innovation and growth.

Dublin, IrelandHeadquarters

1989Year Founded

$8.5MTotal Funding

IPOCompany Stage

Consulting, Enterprise Software, CybersecurityIndustries

10,001+Employees

Risks

Rapid AI advancements may outpace Accenture's current capabilities, risking competitive disadvantages.

Integration challenges from multiple acquisitions could affect Accenture's operational efficiency.

The rise of AI-driven startups may disrupt Accenture's market share in customer service solutions.

Differentiation

Accenture's acquisitions enhance its capabilities in digital twin technology for financial services.

The company is expanding its expertise in net-zero infrastructure through strategic acquisitions.

Accenture's focus on software-defined vehicles positions it as a leader in automotive innovation.

Upsides

Accenture's investment in EMTECH supports central bank modernization amid digital currency evolution.

The acquisition of Award Solutions boosts Accenture's presence in the growing 5G and IoT markets.

Accenture's strategic acquisitions align with high-growth markets like digital twins and net-zero projects.

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