Skill required: Membership - Life Sciences Regulatory Operations
Designation: Health Admin Services Analyst
Qualifications:BSc/BCom/Bachelor of Arts
Years of Experience:3 to 5 years
Language - Ability:English(Domestic) - Intermediate
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, and Accenture Song— all powered by the world’s largest network of Advanced Technology and Intelligent Operations centers. Our 784,000 people deliver on the promise of technology and human ingenuity every day, serving clients in more than 120 countries. We embrace the power of change to create value and shared success for our clients, people, shareholders, partners and communities.Visit us at www.accenture.com
What would you do? Candidate will be working on updating the Member Plan Benefit details as per the details received from Client Need to review and update/modify the plans. Ready to wort. in evening shift (US shift time). Configure health plan benefits in the core payer system (e.g HealthRules). Set up benefit plans based on approved Plan Benefit Packages (PBP) and business requirements. Configure: Coverage rules Deductibles Copays Coinsurance Out-of-pocket Maximums Service Limits Exclusions and authorization requirements. Create and maintain Benefit Plan Components (BPCs). Configure reusable benefit rules and processing logic. Update benefits during annual plan changes, regulatory updates, and client requests. Coordinate the essential documentation and resources required for the filing of global applications. Understand, manage & process electronic submissions that include original application filings, Life Cycle Management submissions such as CMC, Ad-promos, amendments, annual reports, SPL submissions, etc.
What are we looking for? Candidate will be working on updating the Member Plan Benefit details as per the details received from Client. Need to review and update/modify the plans. Ready to wort. in evening shift (US shift time). Configure health plan benefits in the core payer system (e.g HealthRules). Set up benefit plans based on approved Plan Benefit Packages (PBP) and business requirements. Configure: Coverage rules Deductibles Copays Coinsurance Out-of-pocket Maximums Service limits Exclusions and authorization requirements Candidate need to have healthcare claims experience and member benefit update exp.
Roles and Responsibilities: •In this role you are required to do analysis and solving of lower-complexity problems • Your day to day interaction is with peers within Accenture before updating supervisors • In this role you may have limited exposure with clients and/or Accenture management • You will be given moderate level instruction on daily work tasks and detailed instructions on new assignments • The decisions you make impact your own work and may impact the work of others • You will be an individual contributor as a part of a team, with a focused scope of work • Please note that this role may require you to work in fixed shift i.e. US Shift (India evening shift)
BSc,BCom,Bachelor of Arts
