Job Description

About Accenture

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.

What are we looking for?

oAdaptable and flexible

oAbility to work well in a team

oCommitment to quality

oWritten and verbal communication

oProcess-orientation

oHealth Insurance Portability & Accountability Act (HIPAA)

Roles and Responsibilities: oIn this role you are required to solve routine problems, largely

through precedent and referral to general guidelines

• Your primary interaction is within your own team and your direct supervisor

• In this role you will be given detailed instructions on all tasks

• The decisions that you make impact your own work and are closely supervised

• You will be an individual contributor as a part of a team with a predetermined, narrow scope

of work

• Please note that this role may require you to work in rotational shifts

• Manages incoming or outgoing telephone calls, eReviews, and/or faxes, including triage,

opening of cases and data entry into client system.

• 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.

• Performs data entry of contact into client systems and routes as appropriate

• Match fax/clinical records with appropriate case.

• Consolidate inputs for approval.

• Generate needed letters.

• Assign cases/activities and work within client's system to facilitate workflow and productivity

goals.

• Refers cases requiring clinical review to a nurse reviewer. Performs case checks and

reviews to ensure case creation is complete, correct, and "nurse ready".

• Tasks cases accurately to the correct queue.

• Performs Daily Task list maintenance activities under the direction of the Team

Lead/Operations Manager and as per customer workflow.

• Provide administrative support of post service claims utilizing the member's benefit contract

and health plan guidelines.

• Reports inventory numbers and assigns task lists under the direction of the Team

Lead/Operations and as requested by the customer.

• Prioritize follow up and actions based on case request receipt dates, customer workflow,

service level agreements and regulatory timeframes.

Job Type: Full-time

Pay: ?10,844.50 - ?28,495.63 per month

Benefits:

• Cell phone reimbursement
• Food provided
• Health insurance
• Internet reimbursement
• Provident Fund

Schedule:

• Rotational shift

Supplemental pay types:

• Performance bonus

Education:

• Bachelor's (Required)

Language:

• English (Required)

Location:

• Bengaluru, Karnataka (Required)

Work Location: In person