The TPL Denials Management Specialist reviews denials from insurance carriers to determine if denial is valid. Identifies recovery opportunities and communicates with carriers to verify coverage, inquire about claim status and educate carriers about Medicaid rules.
KeyResponsibilities:
- Reviews explanation of benefits (EOB) from insurance carriers
- Analyzes claims to determine if the denial reason is valid or invalid
- Contacts insurance carriers to verify insurance coverage and claim status
- Contacts Medicaid providers to request claim information and/or medical records
- Communicates with insurance carriers regarding invalid denials
- Re-submits claims to carriers
- Performs follow-up to ensure claims are paid
- Works Special Projects
- Actively participates in the development and documentation of work plans and associated procedures
- Works with other departments to coordinate TPL related processes
- Performs other duties as assigned
Shift: Monday - Friday from 8:00 am to 5:00 pm CST.
Basic Qualifications:
- Minimum 2 years of experience working in medical claims
Preferred Skills:
- Microsoft 360
- Medicaid experience
- Medical billing experience
- Third Party Liability experience
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. As required by local law, Accenture provides a reasonable range of compensation for roles that may be hired as set forth below.
We anticipate this job posting will be posted until 10/14/2026.
Accenture offers a market competitive suite of benefits including medical, dental, vision, life, and long-term disability coverage, a 401(k) plan, bonus opportunities, paid holidays, and paid time off. See more information on our benefits here:
Role Location Hourly Salary Range
California $23.13 to $48.13
Colorado $23.13 to $41.59
Connecticut $23.13 to $41.59
District of Columbia $24.62 to $44.28
Illinois $21.39 to $41.59
Maine $19.66 to $35.43
Maryland $23.13 to $41.59
Massachusetts $23.13 to $44.28
Minnesota $23.13 to $41.59
New York $21.39 to $48.13
New Jersey $24.62 to $48.13
Ohio $21.39 to $38.51
Virginia $21.39 to $44.28
Washington $24.62 to $44.28
