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À propos de ce poste DE033965-Customer Service Sr Analyst chez Accenture

Accenture · Sur site · Quezon
---ONLY THOSE APPLICANTS WHO ALREADY HAVE THE RIGHT TO LIVE AND WORK IN THIS COUNTRY ARE ELIGIBLE TO APPLY FOR THIS ROLE--- POSITION TITLE: Customer Service Sr Analyst WORK SETUP: Hybrid RESPONSIBILITIES: • Oversees staff whose primary duties may include, but are not limited to: • Conducts pre-service, concurrent, retrospective, out of network, and appropriateness of treatment setting reviews to ensure compliance with applicable criteria, medical policy, and member eligibility, benefits, and contracts (UM service requests are received from inbound calls and facsimile. Outbound calls to the provider may be required to gather additional information that may be needed) • Responsible for maintaining contractual, regulatory and accreditation compliance by knowing, understanding, correctly interpreting, and accurately applying requirements, regulations and standards. Reports suspected or confirmed issues on the same day of discovery to the manager and/or the Compliance Department. • Responsible for ensuring Associate understanding of contractual, regulatory and accreditation requirements and reporting immediately all suspected or confirmed issues or concerns to a manager and/or the Compliance Department. • Responsible for ensuring that all clinical USRN associates maintain active, documented licensure while working in production. Removes clinical associates from production when active USRN licensure is not verified by the PMO team. Reports instances of expired or lapsed licensure on the date of discovery to the PMO team and to the Compliance Department. • Facilitates accreditation by participating in and/or conducting audits as needed. • Provides leadership, mentoring, and supervision of staff. • Responsible for reporting known or suspected data breaches on the day of discovery to the Compliance Department and for conducting a follow-up investigation as needed. • Performs Root Cause Analysis (RCA) for performance deviations and implement improvement plans and associate coaching as needed. • Studies and analyzes VOC (Voice of customer) trends and customer feedback and work towards improving performance. OTHERS: Project Shift Schedule: Night Shift Project Rest Day: Weekends Off Project/Team Location: Quezon Cyberpark Tower 3

SKILL AND QUALIFICATIONS: • At least 3 years relevant experience; 1 year supervisory experience

About Accenture

Accenture is a leading global professional services company that helps the world’s leading businesses, governments and other organizations build their digital core, optimize their operations, accelerate revenue growth and enhance citizen services—creating tangible value at speed and scale. We are a talent- and innovation-led company with approximately 791,000 people serving clients in more than 120 countries. Technology is at the core of change today, and we are one of the world’s leaders in helping drive that change, with strong ecosystem relationships. We combine our strength in technology and leadership in cloud, data and AI with unmatched industry experience, functional expertise and global delivery capability. Our broad range of services, solutions and assets across Strategy & Consulting, Technology, Operations, Industry X and Song, together with our culture of shared success and commitment to creating 360° value, enable us to help our clients reinvent and build trusted, lasting relationships. We measure our success by the 360° value we create for our clients, each other, our shareholders, partners and communities.

Visit us at www.accenture.com 

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, military veteran status, sexual orientation, gender identity or expression, genetic information, marital status, citizenship status or any other basis as protected by applicable law. Our rich diversity makes us more innovative, more competitive, and more creative, which helps us better serve our clients and our communities.

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À propos de Accenture

Bring your incredible skills and join our global team of innovators. We come together from different backgrounds across the world and work with the latest technologies to create value and growth for our clients. With us, you’ll continue to learn and grow so you can advance in your career. Your personal dreams and ambitions are just as important to us; that’s why we offer support any way we can—when you thrive, we all thrive. Explore your next step at Accenture

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