claims adjudicator AssociateAccenture Philippines

JOB DESCRIPTION:
The Claims Adjudicator is responsible for accurate and timely adjudication of Wellness and Other claims. This may include additional investigation to obtain necessary information (order medical records etc.) to complete the claim review and processing. Duties and responsibilities also include the following:
Core Competencies:
Attention to detail
Proven organizational ability
Reliability
Ability to work independently
Communication Skills
Conveys information clearly and effectively both written and oral
Remains focused on improving communication skills while continuously enhancing knowledge on client products and services
Possesses strong interpersonal skills
Problem Solving
Understands the applicable aspects of the client products/services needed to perform their task
Ability to accurately and quickly perform mathematical calculations
Concentrates on fostering processing efficiencies while meeting quality standards
Displays exemplary analysis and problem-solving capabilities
Teamwork
Works well with others
Develops rapport and trust
Participates actively in team discussions and activities
May assist less experienced or temporary staff when appropriate
Client Focus
Focuses on achieving client and company goals
Flexible and trainable
Aims to maintain excellent relations with the client, client customers (providers), team and internal
Strives to maintain a sound knowledge of the support
Maintains customer focus and service orientation
Security Compliance
• Employees are required to maintain compliance with company safety, security and privacy programs (secrecy of all information and project-related information that may be acquired about the business, its affiliates and partners).
PROCESSES• Claims Processing/Adjudication that will require additional analysis and investigation
JOB QUALIFICATIONS:
• Open to undergraduates with relevant experience
• At least 6 months of work experience in general claims processing procedures
• Working knowledge of MS Office products, with strong Excel and PowerPoint skills
• Able and willing to work U.S. time and as needed, overtime hours (i.e., night shift)
Summary of role requirements:
Looking for candidates available to work on weekdays, Saturdays and Sundays
1 year of relevant work experience required for this role
Working rights required for this role