Government Health Claims Adjudication Lead

Are you a highly organized and detail-oriented individual with a passion for healthcare and government programs? Do you have extensive experience in health claims adjudication and a strong understanding of government regulations and policies? If so, we have an exciting opportunity for you to join our team as a Government Health Claims Adjudication Lead at Accenture.In this role, you will be responsible for leading a team of claims adjudicators in accurately processing and reviewing government health claims for our clients. You will also play a crucial role in ensuring compliance with all relevant regulations and policies, while maintaining a high level of efficiency and quality.We are looking for a proactive and collaborative individual who can effectively communicate and build relationships with both internal and external stakeholders. The ideal candidate will have a minimum of 5 years of experience in health claims adjudication, a deep understanding of government programs such as Medicare and Medicaid, and a strong background in project management.If you are passionate about making a positive impact in the healthcare industry and have the necessary qualifications and skills, we encourage you to apply for this rewarding opportunity. Join us at Accenture and be a part of a dynamic team dedicated to driving innovation and delivering exceptional results in the healthcare sector.

1. Lead a team of claims adjudicators in accurately processing and reviewing government health claims for clients.
2. Ensure compliance with all relevant regulations and policies related to government healthcare programs.
3. Maintain a high level of efficiency and quality in claims adjudication processes.
4. Communicate and build relationships with internal and external stakeholders.
5. Utilize strong project management skills to effectively oversee and coordinate claims adjudication projects.
6. Stay updated on changes and updates to government regulations and policies related to healthcare.
7. Train and develop team members on government healthcare programs and claims adjudication processes.
8. Conduct regular quality control checks to ensure accuracy and consistency in claims processing.
9. Collaborate with other teams and departments to identify and implement process improvements.
10. Analyze data and generate reports to track and measure team and individual performance.
11. Handle escalated or complex claims issues and provide guidance to team members.
12. Serve as a subject matter expert on government healthcare programs and policies.
13. Participate in meetings and presentations with clients to provide updates and address any concerns.
14. Mentor and coach team members to enhance their skills and knowledge.
15. Act as a liaison between the team and upper management, providing updates and recommendations for improvement.

According to JobzMall, the average salary range for a Government Health Claims Adjudication Lead in Chicago, IL, USA is approximately $75,000-$90,000 per year. This may vary depending on factors such as experience, education, and the specific employer.

Accenture is a leading global professional services company providing a range of strategy, consulting, digital, technology & operations services and solutions.