Medical Billing Associate

Medical Billing Associate

Location: Knoxville, TN (location is non-negotiable)

The Medical Billing Associate 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.

Job Requirements

• Must meet Accenture's Primary Residential Location (PRL) Policy for the Knoxville, TN, office location
• Ability to work scheduled shifts as assigned
• Availability for overtime work when required

Basic Qualifications

• Minimum of 1 year of experience in quality auditing and/or claims processing

Preferred Skills

• Experience in outsourcing operations
• Knowledge and experience in any work stream of U.S. healthcare
• Strong analytical and problem-solving skills
• Ability to accurately process and document healthcare claims in multiple systems
• Proficiency in following structured workflows and compliance standards
• Capability to identify discrepancies and escalate issues per SOPs

Professional Qualifications

• Effective communication and collaboration abilities
• Ability to adapt to changing priorities and manage multiple tasks