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What would you do?
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• Experience with Medicare Part C and Part D Appeals.
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• Knowledge of CMS regulations and turnaround requirements.
• 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
• Includes the administration of health, life, and property & causality claims.
• Includes activities involved in core claim processing such as registering claims, editing & verification, claims evaluation, and examination & litigation. What are we looking for?
• Primary skill - Claims Administration - P1
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• Graduate degree.
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• 2 to 4 years healthcare operations experience.
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• Experience in Medicare Appeals and Grievances processing. Roles and Responsibilities:
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• Handle end-to-end appeal processing.
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• Perform AOR validation and provider outreach.
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• Review denial rationale and supporting clinical documentation.
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• Prepare cases for Medical Director review.
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• Process determinations and effectuation activities
• In this role you
📌 Health Admin Services Associate (Navi Mumbai)
🏢 Accenture in India
📍 Navi Mumbai
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