Customer Service Associate

Designation: Customer Service Associate

About The Role

• Focuses on Utilization Management within Healthcare Management.
• Involves evaluating the necessity, appropriateness, and efficiency of healthcare services to ensure patients receive the right care while managing costs effectively.
• Requires reviewing medical records, coordinating with healthcare providers, and making coverage decisions.
• Aims to optimize resource use and improve patient outcomes.
• This role is within Technology and Operations services and Accenture Song.

Key Responsibilities

• Solve routine problems, largely through precedent and referral to general guidelines.
• Interact within your own team and with your direct supervisor.
• Receive detailed to moderate level of instruction on daily work tasks and detailed instruction on new assignments.
• Make decisions that impact your own work.
• Contribute as an individual contributor as part of a team with a predetermined, focused scope of work.
• May require working in rotational shifts.

Requirements & Tech Stack

• Healthcare Utilization Management
• Health Insurance Portability Accountability Act (HIPAA)
• Adaptable and flexible
• Commitment to quality
• Process-orientation
• Written and verbal communication
• Ability to work well in a team

Qualifications

• Any Graduation
• Experience in the administration of hospitals, outpatient clinics, hospices, and other healthcare facilities. This 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.