Health Operations Associate

Billing Agent / Subject Matter Expert (SME)

The Billing Agent / Subject Matter Expert (SME) plays a critical role in supporting a U.S. healthcare client by researching, entering data, and processing or adjusting healthcare appeals and claims across multiple systems and tracking tools. This position requires applying deep process knowledge to identify, assess, and resolve complex issues. As a recognized SME, the individual will troubleshoot and advise on processing guidelines, ensuring compliance with client standards. The role involves handling both standard and non-standard issues and escalating tasks outside established SOPs when necessary.

Key Responsibilities :

• Research and process healthcare appeals and claims using multiple systems and tracking tools.
• Validate claim accuracy and ensure compliance with regulatory requirements.
• Perform root cause analysis for claim discrepancies and implement corrective actions.
• Enter accurate data into designated platforms following client processes.
• Apply knowledge of healthcare processes and systems to resolve complex issues.
• Troubleshoot and provide guidance on processing guidelines as needed.
• Identify and escalate issues outside standard operating procedures.
• Maintain compliance with client-specific workflows and documentation standards.
• Collaborate with internal teams to ensure timely resolution of claims and appeals.
• Monitor and report on claim status and processing metrics.

Basic Qualifications :

Preferred Skills :

Compensation at Accenture varies depending on a wide array of factors, which may include but are not limited to the specific office location, role, skill set, and level of experience. We accept applications on an on-going basis and there is no fixed deadline to apply. Information on benefits is here.

Role Location Hourly Salary Range :

Requesting an Accommodation :

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Equal Employment Opportunity Statement :

We believe that no one should be discriminated against because of their differences. All employment decisions shall be made without regard to age, race, creed, color, religion, sex, national origin, ancestry, disability status, veteran status, sexual orientation, gender identity or expression, genetic information, marital status, citizenship status or any other basis as protected by federal, state, or local law. Our rich diversity makes us more innovative, more competitive, and more creative, which helps us better serve our clients and our communities.

Other Employment Statements :

Applicants for employment in the US must have work authorization that does not now or in the future require sponsorship of a visa for employment authorization in the United States. Candidates who are currently employed by a client of Accenture or an affiliated Accenture business may not be eligible for consideration. Job candidates will not be obligated to disclose sealed or expunged records of conviction or arrest as part of the hiring process. Further, at Accenture a criminal conviction history is not an absolute bar to employment. The Company will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. Additionally, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the Companys legal duty to furnish information. California requires additional notifications for applicants and employees. If you are a California resident, live in or plan to work from Los Angeles County upon being hired for this position, please click here for additional important information. Please read Accenture's Recruiting and Hiring Statement for more information on how we process your data during the Recruiting and Hiring process.