Job Title: Health Operations New Associate
Salary Package: Up to 6 LPA (Expected)
Company Name: Accenture
Job Location: Bangalore
Qualification : Bachelor’s Degree
Job Info:
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 699,000 people deliver on the promise of technology and human ingenuity every day, serving clients in more than 120 countries.
What would you do?
The Healthcare Operations vertical helps our clients drive breakthrough growth by combining deep healthcare delivery experience and subject matter expertise with analytics, automation, artificial intelligence and innovative talent. We help payers, providers and government agencies increase provider, member and group satisfaction, improve health outcomes and reduce costs. You will be a part of the Healthcare Management team which is responsible for the administration of hospitals, outpatient clinics, hospices, and other healthcare facilities.
What are we looking for?
• Healthcare Utilization Management
• Ability to work well in a team
• Adaptable and flexible
• Commitment to quality
• Process-orientation
• Written and verbal communication
• We are looking for voice candidates who will be able to conversant with providers from United States
• Health Insurance Portability & Accountability Act (HIPAA)
Roles and Responsibilities
• In this role you are required to solve routine problems, largely through phone call
• Manages incoming or outgoing telephone calls, eReviews, and/or faxes, including triage, opening of cases and data entry into client system. recedent and referral to general guidelines
• Determines contract; verifies eligibility and benefits.
• Conducts a thorough provider radius search in client system and follows up with provider on referrals given.
• Checks benefits for facility-based treatment.
• Obtains intake (demographic) information from caller, eReview and/or from fax. Processes incoming requests, collection of non-clinical information needed for review from providers, utilizing scripts to screen basic and complex requests for pre-certification and/or prior authorization