Health Consulting | Payer Enrollment and Billing Functional Expert (Manager/Sr. Manager)

 

We work with C-suite executives, leaders and boards of the world’s leading organizations, helping them reinvent every part of their enterprise to drive greater growth, enhance competitiveness, implement operational improvements, reduce cost, deliver sustainable 360° stakeholder value, and set a new performance frontier for themselves and the industry in which they operate. Our deep industry and functional
expertise

is
supported by proprietary assets and solutions that help organizations transform faster and become more resilient. Underpinned by technology, data, analytics, AI, change management, talent and sustainability capabilities, our Strategy & Consulting services help architect and accelerate all aspects of an organization’s total enterprise reinvention.
 

 
 
 

As a

Health
Industry

Enrollment and Billing Functional Expert
, your primary responsibilities
may include:
 
 
 

Functional Expertise

 

Serve as the subject matter expert (SME) for payer enrollment
,
billing
, and financial
processes, including
fully insured,
ASO,
individual (both on and off
exchange
),
Medicare, and Medicaid 
 

Have
deep understanding

of operational integration with
the
upstream and downstream
departments dependent on
enrollment and billing, including
but not limited to sales, marketing, broker operations, claims, fulfillment, remittance,
payment processing,
health plan finance and accounting,
and
risk adjustment
. 
 
 

Analyze and map workflows within enrollment,
billing
and associated team
s
to
identify
inefficiencies and recommend

improvements.
 

Maintain a working knowledge of industry tools and technology
that
support

enrollment and premium billing
operations
 

Client Engagement

 

Collaborate with clients to gather business requirements and translate them into functional specifications.
 

Facilitate workshops and stakeholder meetings to define enrollment and billing system capabilities and future-state processes.
 

Provide strategic recommendations to enhance billing accuracy

and payment reconciliation
with groups, members, third party payers, states, and CMS
 

Project Leadership

 

Drive
high quality
deliverables
by co
ordinating cross-functional teams, managing timelines
, and reporting progress to
client leadership
.
 

Work closely with
operational leaders and
technical teams to ensure
accurate
configuration and customization of enrollment and billing platforms.
 

Client Relationship Management

 

Serve as the primary point of contact for senior client stakeholders, building and
maintaining
strong relationships and
providing
strategic guidance on billing
,

enrollment
and finance
operations
.
 

Conduct regular progress updates, issue resolution, and performance evaluations with clients to ensure engagement success and client satisfaction.
 

Team Leadership and Development

 

Lead and mentor a team of project managers, consultants, and analysts, fostering a collaborative and high-performance environment.
 

Provide
professional development opportunities, coaching, and feedback to build a skilled and motivated team aligned with organizational goals.
 

Thought Leadership and Industry Engagement

 

Stay current with healthcare industry trends, regulatory changes, and emerging technologies related to
billing and enrollment
.
 

Contribute to the firm’s thought leadership through whitepapers, webinars, and industry presentations, positioning the firm as a leader in
billing and enrollment processes
to our healthcare clients.
 
Travel - as needed, up to 80%

 
 

Why should I join the Accenture Health team?

 
 
 
 
 
 

Innovate every day.

Be at the forefront of designing and delivering health technology solutions that push boundaries and create new opportunities for our clients.
 
 
 

Lead with the industry’s best

. Join an industry-recognized healthcare leader with more than 20,000 global healthcare professionals collaborating to drive enterprise-wide transformational projects on a global scale. Accenture has worked with more than 200 clients to deliver healthcare transformation to meet the diverse needs of patients and members.    
 

Learn and grow continuously.

Harness unmatched training and professional development to help you build and advance your health, consultative and delivery
skills. With learning resources, interactive classroom courses, real-life client simulations and ongoing mentoring available when you need it,
you’ll
expand your thinking beyond the core Workday implementation.