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Health Admin Services Analyst

3-5 years
Not Disclosed
10 Aug. 14, 2024
Job Description
Job Type: Full Time Education: B.Sc./ M.Sc./ M.Pharm/ B.Pharm/ Life Sciences Skills: Causality Assessment, Clinical SAS Programming, Communication Skills, CPC Certified, GCP guidelines, ICD-10 CM Codes, CPT-Codes, HCPCS Codes, ICD-10 CM, CPT, HCPCS Coding, ICH guidelines, ICSR Case Processing, Interpersonal Skill, Labelling Assessment, MedDRA Coding, Medical Billing, Medical Coding, Medical Terminology, Narrative Writing, Research & Development, Technical Skill, Triage of ICSRs, WHO DD Coding

Job Title: Health Admin Services Analyst

Skill Required: Payer Eligibility & Enrollment

Qualifications: Any Graduation

Experience: 3 to 5 Years


About Accenture:

Accenture is a global professional services company with leading capabilities in digital, cloud, and security. We combine unmatched experience and specialized skills across more than 40 industries, offering Strategy and Consulting, Technology and Operations services, and Accenture Song. With 699,000 people serving clients in over 120 countries, we create value through technology and human ingenuity. Learn more at www.accenture.com.


Role Overview:

As a Health Admin Services Analyst, you will play a crucial role in healthcare revenue cycle management. You will be responsible for medical billing, insurance verification, and payer eligibility, with a focus on US healthcare systems. Your role will involve coordinating with US clinics and billing offices, managing claims submissions, resolving insurance issues, and maintaining accurate patient and billing records.

Key Responsibilities:

  • Medical Billing: Manage comprehensive revenue cycle management (RCM) processes, including claims submission, charge entries, payment postings, and aging/AR follow-up.
  • Insurance Verification: Verify insurance benefits, handle third-party insurance claims, and resolve issues related to incorrect or incomplete information.
  • Claims Management: Transmit or submit claims (paper and electronic) to insurance payers, review denials, and take corrective actions. Follow up on clinical and non-clinical denials and report the status of delinquent accounts.
  • Communication: Coordinate with US clinics and central billing offices, handle billing inquiries, and communicate effectively with US counterparts via phone and email.
  • Data Management: Maintain patient demographic information in data collection systems, prepare billing reports, and ensure compliance with payer and company policies.
  • Issue Resolution: Research and respond to billing issues and problems through various channels, including telephone, internet, and written communication, to expedite claims processing.

Qualifications and Skills:

  • Education: Bachelor’s degree in Finance, Accounting, Healthcare Administration, or a related field.
  • Experience: 3 to 5 years in medical billing, with a strong understanding of medical terminology and proficiency in ICD-10 and CPT coding.
  • Skills:
    • Excellent knowledge of RCM processing and claims management.
    • Understanding of insurance and benefit verification processes.
    • Proficiency in MS Office Suite and health-related applications/systems.
    • Excellent written and verbal communication skills.
    • Detail-oriented with the ability to identify and correct billing errors.
    • Strong organizational skills and ability to manage multiple tasks in a fast-paced environment.

Working Conditions:

  • Interaction: Daily interactions with peers and supervisors, with occasional exposure to clients.
  • Instructions: Moderate-level instructions for daily tasks and detailed guidance for new assignments.
  • Scope: Individual contributor role with a focused scope of work.
  • Shifts: May require working in rotational shifts.

If you have a strong background in medical billing and payer management, along with excellent communication and organizational skills, we encourage you to apply for this role and contribute to our team at Accenture.