Job Summary
We are seeking a detail-oriented and motivated individual for the role of PE-Claims HC. The candidate will be responsible for processing Medicare and Medicaid claims with precision and efficiency. Proficiency in MS Excel and claims adjudication is essential. This is a night shift work-from-office role requiring strong English communication skills.
Responsibilities
- Process Medicare and Medicaid claims with a high level of accuracy and adherence to regulatory guidelines.
- Utilize MS Excel to analyze organize and validate claims data for efficient processing.
- Ensure timely adjudication of claims while maintaining compliance with company and industry standards.
- Identify discrepancies in claims and take corrective actions to resolve them effectively.
- Collaborate with internal teams to ensure seamless claims processing and issue resolution.
- Maintain up-to-date knowledge of Medicare and Medicaid policies and procedures to ensure compliance.
- Provide detailed documentation of claims adjudication processes and outcomes for audit purposes.
- Communicate effectively with stakeholders to clarify claim-related queries and provide resolutions.
- Monitor claims workflow to ensure deadlines are consistently met without compromising quality.
- Support the team in identifying process improvement opportunities to enhance operational efficiency.
- Adhere to data privacy and confidentiality standards while handling sensitive claim information.
- Participate in training sessions to stay updated on industry trends and software tools.
- Contribute to the companys mission of delivering exceptional service and improving healthcare outcomes.
Qualifications
- Possess strong proficiency in MS Excel including functions such as data analysis and reporting.
- Demonstrate expertise in claims adjudication processes ensuring accuracy and compliance.
- Have a solid understanding of Medicare and Medicaid claims including regulatory requirements.
- Exhibit excellent English communication skills both written and verbal for effective collaboration.
- Show attention to detail and problem-solving skills to handle complex claim scenarios.
- Display the ability to work efficiently in a night shift work-from-office environment.
Certifications Required
Certified Professional Biller (CPB) or equivalent certification in claims processing.
The Cognizant community:
We are a high caliber team who appreciate and support one another. Our people uphold an energetic, collaborative and inclusive workplace where everyone can thrive.
- Cognizant is a global community with more than 300,000+ associates around the world.
- We don’t just dream of a better way – we make it happen.
- We take care of our people, clients, company, communities and climate by doing what’s right.
- We foster an innovative environment where you can build the career path that’s right for you.
About us:
Cognizant (Nasdaq: CTSH) is an AI Builder and technology services provider, building the bridge between AI investment and enterprise value by building full-stack AI solutions for our clients. Our deep industry, process and engineering expertise enables us to build an organization’s unique context into technology systems that amplify human potential, realize tangible returns and keep global enterprises ahead in a fast-changing world. See how at www.cognizant.com or @cognizant.
Cognizant is an equal opportunity employer. Your application and candidacy will not be considered based on race, color, sex, religion, creed, sexual orientation, gender identity, national origin, disability, genetic information, pregnancy, veteran status or any other characteristic protected by federal, state or local laws.
Disclaimer:
Compensation 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.
Applicants may be required to attend interviews in person or by video conference. In addition, candidates may be required to present their current state or government issued ID during each interview.