Job Summary
This hybrid role for a Claims Healthcare Specialist Product Engineer focuses on designing developing and securing claims processing solutions using advanced software practices MS Excel analytics and generative AI ensuring accurate adjudication and compliance for healthcare stakeholders while improving operational efficiency and patient centric outcomes across the organization.
Responsibilities
Design robust healthcare claims processing solutions that streamline adjudication workflows and enhance accuracy across core business processes for internal and external stakeholders.Develop modular software components for claims intake validation and settlement that are optimized for maintainability performance and alignment with healthcare compliance standards.Apply MS Excel to build detailed data analysis models dashboards and reconciliation reports that highlight claims trends anomalies and process optimization opportunities.Implement software security requirements across claims applications by defining secure data handling patterns and enforcing controls that protect sensitive health information throughout its lifecycle.Use generative AI techniques to design and refine intelligent features such as automated documentation assistance and claim pattern detection that reduce manual effort and error rates.Collaborate with business analysts and healthcare operations teams to translate claims policies benefit rules and regulatory constraints into clear and testable software requirements.Conduct unit integration and regression testing of claims modules to confirm functional accuracy security behavior and end to end reliability in line with agreed quality standards.Maintain detailed technical documentation for claims solutions including design decisions security considerations and configuration guidelines to support continuous improvement and onboarding.Monitor production claims systems by reviewing logs error reports and performance metrics then implement targeted fixes and enhancements that sustain system stability and user satisfaction.Optimize existing claims workflows by analyzing operational data in MS Excel and proposing focused automation or rule refinements that shorten settlement timelines and reduce rework.Integrate generative AI services into claims platforms in a controlled manner by validating models against healthcare data quality expectations and documenting safeguards for responsible use.Coordinate with cybersecurity and compliance specialists to ensure all claims software releases satisfy current healthcare privacy regulations and internal risk management policies.Contribute to cross functional initiatives that use claims insights to improve care pathways and cost transparency reinforcing the company mission to deliver better health outcomes and societal impact.
Qualifications
Demonstrate between two and four years of hands on experience in software design and development with specific exposure to healthcare or financial claims systems considered a strong asset.Possess strong practical skills in MS Excel including formulas pivot analysis and data validation combined with solid understanding of software security requirements in regulated environments.Show working experience with generative AI concepts and tools applied to documentation support pattern discovery or workflow optimization within enterprise technology contexts.Bring domain knowledge in healthcare claims processing or insurance operations as a required competency with familiarity across related regulatory and compliance frameworks viewed as beneficial.Offer good to have experience in adjacent domains such as provider billing policy administration or clinical data integration that deepens perspective on end to end healthcare value chains.Work within a hybrid model that balances on site collaboration and remote productivity maintaining clear communication and reliable delivery of commitments in both settings.Operate primarily in a day shift schedule that supports coordination with global stakeholders while preserving flexibility for project demands and incident support when needed.Accept that this position does not require routine travel while remaining open to occasional short visits that may be arranged for critical workshops or stakeholder engagements.Communicate effectively in English through documentation analysis discussions and solution presentations enabling alignment among technical and nontechnical participants.
Certifications Required
Preferred certifications include AZ 900 Microsoft Azure Fundamentals or equivalent security focused credential relevant to enterprise software solutions.
关于高知特 (Cognizant)
高知特(Cognizant)（纳斯达克代码：CTSH）作为一家AI Builder和相关技术服务提供商，致力于通过打造全栈AI解决方案，帮助企业将人工智能投资转化为实际价值。公司凭借深厚的行业经验、流程优化和工程技术专长，将企业独特的业务场景融入科技系统，赋能组织释放人才潜能，推动切实成果，并帮助全球企业在瞬息万变的环境中保持领先。如需了解更多详情，敬请访问 cognizant.ai 或关注@cognizant。
补充雇佣信息
薪酬信息截至本职位发布之日为准。Cognizant 保留在适用法律允许的范围内随时修改该信息的权利。
申请人可能需要通过现场面试或视频会议的方式参加面试。此外，候选人在每次面试时可能需要出示其当前所在州或政府签发的有效身份证件。
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