You are using the web browser we don't support. Please upgrade or use a different browser to improve your experience.
"icon arrow top"

Health Operations Specialist-Healthcare Claims




Mumbai, India


Healthcare & Medical




Not specified

Permanent | Full Time

Skill required: Healthcare Claims - Payer Claims Processing

Designation: Management Level - Team Lead/Consultant

Job Location: Mumbai

Qualifications: BSc/Any Graduation/BMS/BMM

Years of Experience: 7 to 11 years

" target="_blank">

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 Claims team which is responsible for the administration of health claims. This team is involved in core claim processing such as registering claims, editing & verification, claims evaluation, and examination & litigation. In Payer Claims Processing you will be responsible for delivering business solutions that support the healthcare claim function, leveraging a knowledge of the processes and systems to receive, edit, price, adjudicate, and process payments for claims.

What are we looking for?

• Ability to meet deadlines
• Process-orientation
• Strong analytical skills
• Payer Claims Processing
• Attention to detail
• Ready to work in evening shift
• Client communication skill
• Conveys information clearly and effectively both written and verbal
• Ability to work independently
• Team and People management experience
• MSOffice like excel, word, ppt knoweldge
• Ability to prioritize and multi-task
• Client communication skill
• Escalation Management experience
• Able to work on reports
• Manage Client SLAs and KPIs
• Analytical
• Should have experience of handling 50 to 60 users in team
• Performance management
• Health Payor Claims experience

Roles and Responsibilities

• In this role you are required to do analysis and solving of moderately complex problems
• May create new solutions, leveraging and, where needed, adapting existing methods and procedures
• The person would require understanding of the strategic direction set by senior management as it relates to team goals
• Primary upward interaction is with direct supervisor
• May interact with peers and/or management levels at a client and/or within Accenture
• Guidance would be provided when determining methods and procedures on new assignments
• Decisions made by you will often impact the team in which they reside
• Individual would manage small teams and/or work efforts (if in an individual contributor role) at a client or within Accenture
• Please note that this role may require you to work in rotational shifts

Your total rewards

Accenture Flex offers a Total Rewards package which includes compensation recognizing individual contributions and a range of benefits so you can build a coverage package based on your personal needs.

Base pay

We offer a competitive base pay based on your role, career level and skills.

Medical coverage and spending accounts

Employees have a choice of plans (PPO, EPO, HDHP) covering a wide range of medical services and prescription drugs. Use pretax dollars to pay for eligible health care and dependent day care expenses.

Dental and vision coverage

Employees can choose a traditional dental plan or a dental maintenance organization plan. A vision care plan is offered which covers an annual routine eye exam as well as frames, lenses, or contacts.

Life Insurance & Long-Term Disability

Accenture Flex provides you with a basic level of life, AD&D and disability insurance, and you have the option of purchasing additional coverage.

Paid Time Off (PTO)

PTO encompasses traditional vacation time along with paid personal time off and sick leave, providing flexibility for how, when and for what purpose time off is taken.

401(k) Savings plan

Employees are immediately eligible to contribute to a standard 401(k), a Roth, or an after-tax account through convenient payroll deductions and are always vested in their own employee contributions.

Loading please wait...