Medical Claims Examiner (remote)
This is a remote position open to any qualified applicant in the United States.
Job Summary
We are seeking a dedicated Process Executive – HC with 1 to 3 years of experience to join our team. The ideal candidate will have technical expertise in Facets – Claims and preferably domain experience in Payer and Provider. This is a work-from-home position with day shifts and no travel required. The role involves managing claims processes efficiently to support our healthcare operations.
Responsibilities
Manage and process healthcare claims using the Facets system to ensure accuracy and compliance.
Oversee the end-to-end claims lifecycle from submission to resolution to maintain operational efficiency.
Provide support in identifying and resolving discrepancies in claims data to minimize errors.
Collaborate with internal teams to streamline claims processing workflows and improve service delivery.
Ensure adherence to regulatory requirements and company policies in all claims processing activities.
Conduct regular audits of claims data to ensure accuracy and compliance with industry standards.
Utilize domain knowledge in Payer and Provider to enhance claims processing and customer satisfaction.
Maintain up-to-date knowledge of industry trends and changes in healthcare regulations to ensure compliance.
Assist in the development and implementation of process improvements to enhance operational efficiency.
Provide training and support to new team members to ensure they are proficient in claims processing.
Generate reports and analyze claims data to identify trends and areas for improvement.
Communicate effectively with stakeholders to resolve issues and provide updates on claims status.
Participate in team meetings and contribute to discussions on process improvements and best practices.
Qualifications
Possess a minimum of 1 to 3 years of experience in healthcare claims processing.
Demonstrate technical expertise in using the Facets system for claims management.
Exhibit strong analytical skills to identify and resolve discrepancies in claims data.
Have domain knowledge in Payer and Provider to enhance claims processing.
Show proficiency in regulatory compliance and industry standards related to healthcare claims.
Display excellent communication skills to interact with stakeholders and team members.
Be capable of working independently in a work-from-home environment.
Demonstrate the ability to manage multiple tasks and prioritize effectively.
Exhibit a proactive approach to identifying and implementing process improvements.
Possess strong attention to detail to ensure accuracy in claims processing.
Show a commitment to continuous learning and staying updated on industry trends.
Be proficient in using relevant software and tools for claims processing and data analysis.
Have a collaborative mindset to work effectively with cross-functional teams.
Applications will be accepted until: November 1. 2024
The hourly rate for this position is between $18.00- 19.00 per hour, depending on experience and other
qualifications of the successful candidate.
This position is also eligible for Cognizant’s discretionary annual incentive program, based on performance and
subject to the terms of Cognizant’s applicable plans.
Benefits: Cognizant offers the following benefits for this position, subject to applicable eligibility requirements:
Medical/Dental/Vision/Life Insurance
Paid holidays plus Paid Time Off
401(k) plan and contributions
Long-term/Short-term Disability
Paid Parental Leave
Employee Stock Purchase Plan
Disclaimer: The hourly rate, other compensation, and benefits information is accurate as of the date of this
posting. Cognizant reserves the right to modify this information at any time, subject to applicable law.
Cognizant
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