Health Admin Services New Associate (Voice) | Claims Appeals | Bengaluru
Company: Accenture
Location: Bengaluru
Job Type: Full-Time
Work Mode: On-site (Rotational Shifts)
Experience: 0–2 Years
Qualification: Any Graduation / Nursing (GNM / BSc Nursing / Diploma)
Job Overview
This is an entry-level opportunity in healthcare operations and insurance claims management, ideal for candidates looking to build a career in claims appeals, medical review, and healthcare administration.
As a Health Admin Services Associate (Voice), you will handle claims appeals processing, medical necessity review, and provider/member communication, ensuring accurate and compliant healthcare claim decisions. The role blends clinical understanding with process-driven operations, making it highly relevant for candidates from life sciences, nursing, and healthcare backgrounds.
Key Responsibilities
Claims Appeals & Healthcare Operations
Process pre-service and retrospective claims appeals (inpatient & outpatient)
Review denied claims and evaluate medical necessity and eligibility criteria
Ensure compliance with healthcare policies, contracts, and clinical guidelines
Clinical Review & Decision Support
Utilize tools like Milliman / InterQual criteria for decision-making
Analyze clinical documentation and determine:
Approval
Additional information requirement
Escalation to medical reviewers
Route complex cases to medical staff or clinical reviewers
Voice Process & Communication
Communicate with providers, members, and stakeholders via voice support
Explain claim decisions and gather additional information
Maintain high-quality customer interaction and service standards
Compliance & Quality Assurance
Ensure adherence to HIPAA, healthcare regulations, and client policies
Support accurate documentation and case processing
Maintain quality, efficiency, and turnaround timelines
Required Skills & Qualifications
Education & Eligibility
Any Graduate OR
Nursing Qualification: GNM / BSc Nursing / Diploma / BSN
RN License preferred (mandatory for clinical pathway roles)
Experience
0–1 year experience in healthcare, BPO, or clinical environment
Minimum 3 months (≈480 hours) RN clinical experience (if nursing background)
Core Skills & Knowledge
Understanding of:
Claims Processing & Appeals Management
Medical Necessity Review
Healthcare Policies & Insurance Guidelines
Familiarity with:
Milliman / InterQual Criteria (preferred)
HIPAA Compliance & Healthcare Regulations
Technical & Communication Skills
Strong English communication (Voice process)
Must clear Berlitz B2 / Versant 58+ (or equivalent)
Basic computer skills and ability to learn new systems
Soft Skills
Strong analytical and decision-making ability
Attention to detail and process-oriented mindset
Ability to work in rotational shifts and fast-paced environment
Perks & Benefits
Opportunity to work in global healthcare operations & claims management
Strong career path in medical coding, claims analysis, and healthcare BPO
Access to training programs and skill development initiatives
Exposure to international healthcare systems and compliance standards
Inclusive and performance-driven work culture
About the Company
Accenture is a leading global organization delivering technology, consulting, and healthcare operations services. With a strong presence in life sciences and healthcare, Accenture enables organizations to improve patient outcomes, operational efficiency, and digital transformation at scale.
Salary / Compensation
💰 Not disclosed in the job description (Competitive entry-level package expected)
Work Mode
📍 On-site – Bengaluru, India (Rotational Shifts – Voice Process)
Call to Action
If you’re looking to start your career in healthcare operations, claims management, or clinical support roles, this is a strong entry point into the industry.
👉 Apply now and begin your journey in global healthcare services and insurance operations.
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