Healthcare Customer Service Associate - Utilization Management

Customer Service Associate

Skill required: HM- Utilization Management - Healthcare Management
Designation: Customer Service Associate
Qualifications:Any Graduation
Years of Experience:1 to 3 years
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? Embedding digital transformation in healthcare operations end-to-end, driving superior outcomes and value realization today, and enabling streamlined operations to serve the emerging health care market of tomorrow HM- Utilization Management involves evaluating the necessity, appropriateness, and efficiency of healthcare services. The goal is to ensure patients receive the right care while managing costs effectively. Responsibilities include reviewing medical records, coordinating with healthcare providers, and making coverage decisions. This role requires strong analytical skills and knowledge of healthcare regulations. It is essential for optimizing resource use and improving patient outcomes. The administration of hospitals, outpatient clinics, hospices, and other healthcare facilities. This experience includes day to day operations, department activities, medical and health services, budgeting and rating, research and education, policies and procedures, quality assurance, patient services, and public relations.
What are we looking for? •Healthcare Utilization Management •Ability to work well in a team •Adaptable and flexible •Commitment to quality •Process-orientation •Written and verbal communication •Health Insurance Portability & Accountability Act (HIPAA)
Roles and Responsibilities: •In this role you are required to solve routine problems, largely through precedent and referral to general guidelines • Your expected interactions are within your own team and direct supervisor • You will be provided detailed to moderate level of instruction on daily work tasks and detailed instruction on new assignments • The decisions that you make would impact your own work • You will be an individual contributor as a part of a team, with a predetermined, focused scope of work • Please note that this role may require you to work in rotational shifts