At Accenture, on contract for Health Care Service Corporation, I review US healthcare claims in the Claim Integrity function. I process claims within SLA timelines and check CPT codes, billing records, and coverage policies to validate eligibility and help prevent incorrect payouts.
I identify overpayments, documentation gaps, and policy mismatches before adjudication, and perform internal quality checks. I use Claims GUI and workflow systems for end-to-end claims adjudication, with a focus on compliance and accuracy.
